DISTINCTIVE DERMATOLOGYLTD
NPI 1518028398
Dermatology in Swansea, IL

Active since December 13, 2006CLIA 14D0434047 · Certificate of Compliance
510 FULLERTON RD, SWANSEA, IL 62226(618) 233-7666(618) 233-7461 Get Directions Write a Review

NPPES record last updated: December 26, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Distinctive Dermatologyltd NPPES

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

DISTINCTIVE DERMATOLOGYLTD (NPI 1518028398), doing business as Gregory & Associates Dermatology, Ltd, is a healthcare organization registered as a dermatology in Swansea, Illinois and active in the NPI registry since December 2006. The organization holds a CLIA Certificate of Compliance certificate valid through October 29, 2026 and lists Susan L. Journagan, President, as its authorized official.

NPPES Registry Identity

NPI1518028398
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameDISTINCTIVE DERMATOLOGYLTD
Location Address510 FULLERTON RDSwansea, IL 62226-2970
Mailing Address510 Fullerton RoadSwansea, IL 62226-2970 · (618) 233-7666 · Fax (618) 233-7461
Fax(618) 233-7461
Organization SubpartNo
Authorized OfficialSusan L. JournaganPresident · (618) 233-7666
Enumeration DateDecember 13, 2006
Last NPPES UpdateDecember 26, 2014
✔ NPI 1518028398 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.
Also ListedNurse PractitionerTaxonomy 363L00000X
510 FULLERTON RD, Swansea, IL 62226

Other Names 1

Former Legal Business NameGregory & Associates Dermatology, Ltd

Other Identifiers 3

OtherCA2289IL · Medicare Rr Group Ptan
Medicare PIN796600IL
Other8200530IL · Bcbs Group Legacy #

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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)

Distinctive Dermatologyltd 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 Distinctive Dermatologyltd, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 6 within 10 miles. They are listed nearest first.

Clinicians, nearest first (6)

Nurse Practitioner
NPI 1497732382
510 FULLERTON RD
Swansea, IL 62226
(618) 233-7666
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1669358396
390 OFFICE CT
Fairview Heights, IL 62208
(618) 233-7666
✔ PECOS✔ Accepts Medicare4.4 mi
Dermatology
NPI 1023220464
390 OFFICE COURT
Fairview Heights, IL 62208
(618) 233-7666
✔ PECOS✔ Accepts Medicare4.4 mi
Dermatology
NPI 1598987836
390 OFFICE COURT
Fairview Heights, IL 62208
(618) 233-7666
✔ PECOS✔ Accepts Medicare4.4 mi
Dermatology
NPI 1124361159
390 OFFICE CT
Fairview Heights, IL 62208
(618) 233-7666
✔ PECOS✔ Accepts Medicare4.4 mi
Dermatology
NPI 1134432065
390 OFFICE CT
Fairview Heights, IL 62208
(618) 233-7666
✔ PECOS✔ Accepts Medicare4.4 mi

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

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 14D0434047

Distinctive Dermatology · Fairview Heights, IL
Active · expires Oct 29, 2026
CLIA Number14D0434047
Laboratory TypePhysician Office
Certificate Effective DateOctober 30, 2024
Certificate Expiration DateOctober 29, 2026
Laboratory DirectorAngela M. Sutton
Laboratory Phone(618) 233-7666
Laboratory LocationDistinctive Dermatology390 Office Ct, Fairview Heights, IL 62208
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Distinctive Dermatologyltd's NPI number?

The NPI number for Distinctive Dermatologyltd is 1518028398. It was assigned to this organization in the NPPES registry on December 13, 2006. The provider was formerly known as Gregory & Associates Dermatology, Ltd.

Where is Distinctive Dermatologyltd located?

Distinctive Dermatologyltd is located at 510 Fullerton Rd, Swansea, IL 62226. The listed phone number is (618) 233-7666.

What is Distinctive Dermatologyltd's specialty?

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

Is Distinctive Dermatologyltd enrolled in Medicare?

Yes. Distinctive Dermatologyltd is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Distinctive Dermatologyltd?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Distinctive Dermatologyltd. 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. The largest specialties are Dermatology (4) and Nurse Practitioner (2). Of these, 1 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Distinctive Dermatologyltd hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 14D0434047) is associated with this NPI, valid through October 29, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Distinctive Dermatologyltd accept?

Health plans from Anthem Blue Cross and Blue Shield and Medica list Distinctive Dermatologyltd 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 Distinctive Dermatologyltd was last updated on December 26, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.