GRAND ISLAND DERMATOLOGY PC
NPI 1609836535
Dermatology in Grand Island, NE

Q: What is Grand Island Dermatology PC's NPI number?

The NPI number for Grand Island Dermatology PC is 1609836535. It was assigned to this organization in the NPPES registry on March 24, 2006.

Q: What is Grand Island Dermatology PC's specialty?

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

Active since March 24, 2006CLIA Certified · 2 labs

418 N WEBB RD, GRAND ISLAND, NE 68803(308) 384-9300(308) 384-4542 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Jun 9, 2017, Jun 1, 2017 (3 updates tracked since 2017).

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About Grand Island Dermatology Pc NPPES

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

GRAND ISLAND DERMATOLOGY PC (NPI 1609836535) is a healthcare organization registered as a dermatology in Grand Island, Nebraska and active in the NPI registry since March 2006. The organization holds 2 active CLIA laboratory certificates and lists Patrick L Sheridan, Administrator, as its authorized official.

NPPES Registry Identity

NPI1609836535

Entity TypeOrganization

Primary Taxonomy207N00000X

Legal Business NameGRAND ISLAND DERMATOLOGY PC

Location Address418 N WEBB RDGrand Island, NE 68803-4045

Mailing AddressPo Box 5436Grand Island, NE 68802-5436 · (308) 384-9300 · Fax (308) 384-4542

Phone(308) 384-9300

Fax(308) 384-4542

Organization SubpartNo

Authorized OfficialPatrick L SheridanAdministrator · (308) 384-9300

Enumeration DateMarch 24, 2006

Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration

✔ NPI 1609836535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

License✔ Licensed in NE · 22426

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 ListedSpecialistTaxonomy 174400000X · License 22426 (NE)

418 N WEBB RD, Grand Island, NE 68803

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Other Identifiers 2

Other01726NE · Bcbs Of Ne

Medicaid10025016800NE

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

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

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 for Provider-Performed Microscopy Procedures (PPMP) 28D1017055

Grand Island Dermatology PC · Grand Island, NE

Active · expires Sep 15, 2027

CLIA Number28D1017055

Laboratory TypePhysician Office

Certificate Effective DateSeptember 16, 2025

Certificate Expiration DateSeptember 15, 2027

Laboratory DirectorDr. Jennifer H. Alberts

Laboratory Phone(308) 384-9300

Laboratory LocationGrand Island Dermatology PC418 N Webb Road, Grand Island, NE 68803

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Compliance 28D2116830

Grand Island Dermatology · Grand Island, NE

Active · expires Dec 20, 2026

CLIA Number28D2116830

Laboratory TypePhysician Office

Certificate Effective DateDecember 21, 2024

Certificate Expiration DateDecember 20, 2026

Laboratory DirectorDr. Brent W. Keenportz

Laboratory Phone(308) 384-9300

Laboratory LocationGrand Island Dermatology418 N Webb Road, Grand Island, NE 68803

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.

Other Providers at the Same Location NPPES 11

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

PATRICK L SHERIDAN

Hearing Instrument Specialist