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HAMBLIN DERMATOLOGY PLLC
NPI 1568851350
Dermatology in Show Low, AZ

Active since January 15, 2015CLIA Certified · 3 labs
5300 S SUTTER DR STE 1, SHOW LOW, AZ 85901(928) 532-7546 Get Directions Write a Review

NPPES record last updated: December 19, 2024. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Dec 19, 2024, May 13, 2020, Nov 18, 2015 (3 updates tracked since 2015).

About Hamblin Dermatology Pllc NPPES

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

HAMBLIN DERMATOLOGY PLLC (NPI 1568851350) is a healthcare organization registered as a dermatology in Show Low, Arizona and active in the NPI registry since January 2015. The organization holds 3 active CLIA laboratory certificates and lists Travis Hamblin, Owner, as its authorized official.

NPPES Registry Identity

NPI1568851350
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameHAMBLIN DERMATOLOGY PLLC
Location Address5300 S SUTTER DR STE 1Show Low, AZ 85901-8055
Mailing Address5300 S Sutter Dr Ste 1Show Low, AZ 85901-8055 · (928) 532-7546
Phone(928) 532-7546
Organization SubpartNo
Authorized OfficialTravis HamblinOwner · (928) 532-7546
Enumeration DateJanuary 15, 2015
Last NPPES UpdateDecember 19, 20243 updates tracked since enumeration
NPPES CertifiedDecember 19, 2024
✔ NPI 1568851350 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.
5300 S SUTTER DR STE 1, Show Low, AZ 85901
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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 MULTIPLE SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Hamblin Dermatology Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Hamblin Dermatology PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Travis Hamblin, D.O.
Dermatology
NPI 1427344415
5300 S SUTTER DR STE 1
Show Low, AZ 85901
(928) 532-7546
✔ PECOS✔ Accepts MedicareSame address
Ashlee Nicoll, NP
Nurse Practitioner
NPI 1164040945
114 S MOUNTAIN AVE
Springerville, AZ 85938
(928) 333-4368
✔ PECOS✔ Accepts Medicare42 mi
Anthony Yerkovich
Nurse Practitioner
NPI 1861362188
1100 N BROAD ST STE E
Globe, AZ 85501
(928) 532-7546
✔ PECOS✔ Accepts Medicare71 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 3

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 03D2102434

Hamblin Dermatology PLLC · Show Low, AZ
Active · expires Jul 31, 2028
CLIA Number03D2102434
Laboratory TypePhysician Office
Certificate Effective DateAugust 1, 2026
Certificate Expiration DateJuly 31, 2028
Laboratory DirectorTravis W. Hamblin
Laboratory Phone(928) 532-7546
Laboratory LocationHamblin Dermatology PLLC5300 S Sutter Dr Ste 1, Show Low, AZ 85901
CLIA data matches this NPI record on: Address 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.

Certificate of Compliance 03D2307616

Hamblin Dermatology · Globe, AZ
Active · expires Apr 23, 2028
CLIA Number03D2307616
Laboratory TypePhysician Office
Certificate Effective DateApril 24, 2026
Certificate Expiration DateApril 23, 2028
Laboratory DirectorTravis W. Hamblin
Laboratory Phone(928) 532-7546
Laboratory LocationHamblin Dermatology1100 N Broad St Ste E, Globe, AZ 85501
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.

Certificate of Compliance 03D2307620

Hamblin Dermatology Dba Copper State Dermatology And Mohs Surgery · Gilbert, AZ
Active · expires Apr 6, 2028
CLIA Number03D2307620
Laboratory TypePhysician Office
Certificate Effective DateApril 7, 2026
Certificate Expiration DateApril 6, 2028
Laboratory DirectorTravis W. Hamblin
Laboratory Phone(928) 532-7546
Laboratory LocationHamblin Dermatology Dba Copper State Dermatology And Mohs Surgery7400 S Power Rd Ste 118, Gilbert, AZ 85297
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 Hamblin Dermatology PLLC's NPI number?

The NPI number for Hamblin Dermatology PLLC is 1568851350. It was assigned to this organization in the NPPES registry on January 15, 2015.

Where is Hamblin Dermatology PLLC located?

Hamblin Dermatology PLLC is located at 5300 S Sutter Dr Ste 1, Show Low, AZ 85901. The listed phone number is (928) 532-7546.

What is Hamblin Dermatology PLLC's specialty?

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

Is Hamblin Dermatology PLLC enrolled in Medicare?

Yes. Hamblin Dermatology PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Hamblin Dermatology PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Hamblin Dermatology PLLC, in Dermatology and Nurse Practitioner. 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.

Does Hamblin Dermatology PLLC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Hamblin Dermatology PLLC was last updated on December 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.