VANGUARD MEDICAL SPECIALISTS LLC
NPI 1366062994
Dermatology in Canon City, CO

NPI Status: Active since April 23, 2020

Contact Information

109 LATIGO LN STE F
CANON CITY, CO
ZIP 81212
Phone: (719) 355-1585

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  • Organization
  • Dermatology
  • CLIA Number: 06D2052978
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 09-25-2027

About VANGUARD MEDICAL SPECIALISTS LLC

This page provides the complete NPI Profile along with additional information for Vanguard Medical Specialists Llc, a provider established in Canon City, Colorado operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1366062994 assigned on April 2020. The practitioner's primary taxonomy code is 207N00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Vanguard Medical Specialists Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Amber Gust-allen (Revenue Cycle Manager)

NPI
1366062994
Provider Name
VANGUARD MEDICAL SPECIALISTS LLC
Entity Type
Organization
Location Address
109 LATIGO LN STE F CANON CITY, CO 81212
Location Phone
(719) 355-1585
Mailing Address
PO BOX 5088 DENVER, CO 80217
Mailing Phone
(719) 355-1585
Mailing Fax
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-23-2020
Last Update Date
04-01-2024
Code Navigator

A dermatologist like Vanguard Medical Specialists Llc 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.

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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
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

 
2207ND0900XAllopathic & Osteopathic Physicians

Dermatology
Dermatopathology

 
3207NP0225XAllopathic & Osteopathic Physicians

Dermatology
Pediatric Dermatology

 
4207NS0135XAllopathic & Osteopathic Physicians

Dermatology
Procedural Dermatology

 
5207YS0123XAllopathic & Osteopathic Physicians

Otolaryngology
Facial Plastic Surgery

 
6207YX0007XAllopathic & Osteopathic Physicians

Otolaryngology
Plastic Surgery within the Head & Neck

 
7207YX0905XAllopathic & Osteopathic Physicians

Otolaryngology
Otolaryngology/Facial Plastic Surgery

 
8208200000XAllopathic & Osteopathic Physicians

Plastic Surgery

 
92082S0099XAllopathic & Osteopathic Physicians

Plastic Surgery
Plastic Surgery Within the Head and Neck

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas 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

AMBER GUST-ALLEN

Authorized Official Title
REVENUE CYCLE MANAGER
Authorized Official Phone
(719) 465-5643

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
06D2052978
Facility Type
Physician Office
Certificate Effective Date
September 26, 2025
Certificate Expiration Date
September 25, 2027
Laboratory Director
DR. RENATA OLIVEIRA PRADO
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Vanguard Medical Specialists Llc 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 1366062994, 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
6
Doubled → 12 → 1 + 2
Pos 4
6
Unchanged
Pos 5
0
Doubled → 0
Pos 6
6
Unchanged
Pos 7
2
Doubled → 4
Pos 8
9
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
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 6 → 12 → 3 0 → 0 2 → 4 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

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

2 + 3 + 1 + 2 + 6 + 0 + 6 + 4 + 9 + 1 + 8 + 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 1366062994.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1366062994, enumerated as an "organization" on April 23, 2020.

The provider is located at 109 LATIGO LN STE F CANON CITY, CO 81212 and the phone number is (719) 355-1585.

Dermatology with taxonomy code 207N00000X.