ADVANCED DERMATOLOGY OF WYOMING, INC
NPI 1427408319
Dermatology in Jackson, WY

Active since June 21, 2016
62 SOUTH REDMOND STREET, JACKSON, WY 83001(307) 734-5864 Get Directions Write a Review

NPPES record last updated: October 6, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Advanced Dermatology Of Wyoming, Inc NPPES

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

ADVANCED DERMATOLOGY OF WYOMING, INC (NPI 1427408319) is a healthcare organization registered as a dermatology in Jackson, Wyoming and active in the NPI registry since June 2016. The organization lists Linda Crandall, Credentialing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1427408319
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameADVANCED DERMATOLOGY OF WYOMING, INC
Location Address62 SOUTH REDMOND STREETJackson, WY 83001-8664
Mailing AddressPo Box 7406Jackson, WY 83002-7406 · (307) 734-5864
Organization SubpartNo
Authorized OfficialLinda CrandallCredentialing Coordinator · (970) 484-3050
Enumeration DateJune 21, 2016
Last NPPES UpdateOctober 6, 2016
✔ NPI 1427408319 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
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.
62 SOUTH REDMOND STREET, Jackson, WY 83001

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

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Advanced Dermatology Of Wyoming, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to Advanced Dermatology Of Wyoming, Inc, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (6)

Dermatology
NPI 1942662788
62 REDMOND ST
Jackson, WY 83001
(505) 514-8705
✔ PECOS✔ Accepts MedicareSame address
Dermatology
NPI 1871814236
1120 E ELIZABETH ST SUITE G-2
Fort Collins, CO 80524
(970) 484-6303
✔ PECOS✔ Accepts Medicare355 mi
Dermatology
NPI 1104856061
3480 WOLVERINE DR STE F
Montrose, CO 81401
(970) 252-7444
✔ PECOS✔ Accepts Medicare379 mi
Dermatology
NPI 1043452139
27776 WOODWARD AVE
Royal Oak, MI 48067
(248) 355-5047
✔ PECOS✔ Accepts Medicare1,393 mi
Dermatology
NPI 1619918166
2320 DOUBLE CHURCHES RD SUITE B
Columbus, GA 31909
(706) 649-4000
✔ PECOS1,587 mi
Dermatology
NPI 1932193729
12497 TAMIAMI TRL S STE 1
North Port, FL 34287
(941) 282-3376
✔ PECOS✔ Accepts Medicare1,953 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Advanced Dermatology Of Wyoming, Inc's NPI number?

The NPI number for Advanced Dermatology Of Wyoming, Inc is 1427408319. It was assigned to this organization in the NPPES registry on June 21, 2016.

Where is Advanced Dermatology Of Wyoming, Inc located?

Advanced Dermatology Of Wyoming, Inc is located at 62 South Redmond Street, Jackson, WY 83001. The listed phone number is (307) 734-5864.

What is Advanced Dermatology Of Wyoming, Inc's specialty?

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

Is Advanced Dermatology Of Wyoming, Inc enrolled in Medicare?

Yes. Advanced Dermatology Of Wyoming, Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Advanced Dermatology Of Wyoming, Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians, all in Dermatology, reassign their Medicare billing to Advanced Dermatology Of Wyoming, Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Advanced Dermatology Of Wyoming, Inc accept?

Health plans from Blue Cross Blue Shield of Wyoming list Advanced Dermatology Of Wyoming, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Advanced Dermatology Of Wyoming, Inc was last updated on October 6, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.