RED LEDGES DERMATOLOGY PLLC
NPI 1417467986
Dermatology in St George, UT

Active since October 10, 2017CLIA 46D2174004 · Certificate of Compliance
1449 N 1400 W STE 22, ST GEORGE, UT 84770(435) 703-9296 Get Directions Write a Review

NPPES record last updated: March 8, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 8, 2018, Oct 10, 2017 (2 updates tracked since 2017).

About Red Ledges Dermatology Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RED LEDGES DERMATOLOGY PLLC (NPI 1417467986) is a healthcare organization registered as a dermatology in St George, Utah and active in the NPI registry since October 2017. The organization holds a CLIA Certificate of Compliance certificate valid through August 18, 2027 and lists Warren Albert Petererson, Owner, as its authorized official.

NPPES Registry Identity

NPI1417467986
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameRED LEDGES DERMATOLOGY PLLC
Location Address1449 N 1400 W STE 22St George, UT 84770-5237
Mailing Address1449 N 1400 W Ste 22St George, UT 84770-5237 · (435) 703-9296
Organization SubpartNo
Authorized OfficialWarren Albert PeterersonOwner · (435) 703-9296
Enumeration DateOctober 10, 2017
Last NPPES UpdateMarch 8, 20182 updates tracked since enumeration
NPI 1417467986 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License Licensed in UT · 179077-1204
Definition
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.
1449 N 1400 W STE 22, St George, UT 84770

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 46D2174004

Red Ledges Dermatology · St George, UT
Active · expires Aug 18, 2027
CLIA Number46D2174004
Laboratory TypePhysician Office
Certificate Effective DateAugust 19, 2025
Certificate Expiration DateAugust 18, 2027
Laboratory DirectorMichael W. Peterson
Laboratory Phone(801) 704-7001
Laboratory LocationRed Ledges Dermatology1449 N 1400 W, #22, St George, UT 84770
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
1449 N 1400 W STE 22
ST GEORGE, UT 84770

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Red Ledges Dermatology PLLC's NPI number?

The NPI number for Red Ledges Dermatology PLLC is 1417467986. It was assigned to this organization in the NPPES registry on October 10, 2017.

Where is Red Ledges Dermatology PLLC located?

Red Ledges Dermatology PLLC is located at 1449 N 1400 W Ste 22, St George, UT 84770. The listed phone number is (435) 703-9296.

What is Red Ledges Dermatology PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Red Ledges Dermatology PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 46D2174004) is associated with this NPI, valid through August 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Red Ledges Dermatology PLLC was last updated on March 8, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.