NEW DERMATOLOGY GROUP LTD
NPI 1356784334
Dermatology in Green Bay, WI

NPI Status: Active since April 09, 2013

Contact Information

1747 SHAWANO AVE
GREEN BAY, WI
ZIP 54303
Phone: (920) 965-0345

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  • Organization
  • Dermatology
  • CLIA Number: 52D2106871
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 04-19-2028

About NEW DERMATOLOGY GROUP LTD

This page provides the complete NPI Profile along with additional information for New Dermatology Group Ltd, a provider established in Green Bay, Wisconsin operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1356784334 assigned on April 2013. The practitioner's primary taxonomy code is 207N00000X with license number 53110-20 (WI). The provider is registered as an organization and their NPI record was last updated 13 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Kevan Lewis (Owner)

NPI
1356784334
Provider Name
NEW DERMATOLOGY GROUP LTD
Entity Type
Organization
Location Address
1747 SHAWANO AVE GREEN BAY, WI 54303
Location Phone
(920) 965-0345
Mailing Address
2221 S WEBSTER AVE STE 241 GREEN BAY, WI 54301
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-09-2013
Last Update Date
04-09-2013
Code Navigator

A dermatologist like New Dermatology Group Ltd is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dermatology

Taxonomy Code
207N00000X
Type
Allopathic & Osteopathic Physicians
License No.
53110-20
License State
WI
Taxonomy Description
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207ND0101XAllopathic & Osteopathic Physicians

Dermatology
MOHS-Micrographic Surgery

53110-20 (WI)
2207ND0900XAllopathic & Osteopathic Physicians

Dermatology
Dermatopathology

53110-20 (WI)
3207NI0002XAllopathic & Osteopathic Physicians

Dermatology
Clinical & Laboratory Dermatological Immunology

53110-20 (WI)
4207NS0135XAllopathic & Osteopathic Physicians

Dermatology
Procedural Dermatology

53110-20 (WI)

Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KEVAN LEWIS

Authorized Official Title
OWNER
Authorized Official Phone
(920) 965-0345

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
52D2106871
Facility Type
Physician Office
Certificate Effective Date
April 20, 2026
Certificate Expiration Date
April 19, 2028
Laboratory Director
DR. KEVAN G. LEWIS
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to New Dermatology Group Ltd after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1356784334, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
6
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
8
Unchanged
Pos 7
4
Doubled → 8
Pos 8
3
Unchanged
Pos 9
3
Doubled → 6
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 7 → 14 → 5 4 → 8 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 1 + 0 + 6 + 1 + 4 + 8 + 8 + 3 + 6 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1356784334.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Chiropractor
1747 SHAWANO AVE
GREEN BAY, WI 54303

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1356784334, enumerated as an "organization" on April 09, 2013.

The provider is located at 1747 SHAWANO AVE GREEN BAY, WI 54303 and the phone number is (920) 965-0345.

Dermatology with taxonomy code 207N00000X.