1. Home
  2. Directory
  3. Kansas
  4. Overland Park
  5. Dermatology
  6. NPI Profile

ADULT AND PEDIATRIC DERMATOLOGY
NPI 1609966753
Dermatology in Overland Park, KS

Active since October 12, 2006CLIA 17D0687168 · Microscopy
4601 W 109TH ST STE 116, OVERLAND PARK, KS 66211(913) 469-1115(913) 469-9192 Get Directions Write a Review

NPPES record last updated: July 13, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Adult And Pediatric Dermatology NPPES

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

ADULT AND PEDIATRIC DERMATOLOGY (NPI 1609966753) is a healthcare organization registered as a dermatology in Overland Park, Kansas and active in the NPI registry since October 2006. The organization holds a CLIA Microscopy certificate valid through August 31, 2027 and lists Jenean C Kemp, Administrator, as its authorized official.

NPPES Registry Identity

NPI1609966753
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameADULT AND PEDIATRIC DERMATOLOGY
Location Address4601 W 109TH ST STE 116Overland Park, KS 66211-1313
Mailing Address4601 W. 109th Street, Suite 116Overland Park, KS 66211-1313 · (913) 469-1115 · Fax (913) 469-9192
Phone(913) 469-1115
Fax(913) 469-9192
Organization SubpartNo
Authorized OfficialJenean C KempAdministrator · (913) 948-9184
Enumeration DateOctober 12, 2006
Last NPPES UpdateJuly 13, 2022
NPPES CertifiedJuly 13, 2022
✔ NPI 1609966753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in KS · 0422209
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.
4601 W 109TH ST STE 116, Overland Park, KS 66211
Open in Google Maps ↗

Other Identifiers 1

OtherCI3423KS · Medicare Railroad

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 for Provider-Performed Microscopy Procedures (PPMP) 17D0687168

Adult And Pediatric Dermatology · Overland Park, KS
Active · expires Aug 31, 2027
CLIA Number17D0687168
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2025
Certificate Expiration DateAugust 31, 2027
Laboratory DirectorDavid L. Kaplan MD
Laboratory Phone(913) 469-1115
Laboratory LocationAdult And Pediatric Dermatology4601 W 109th St Ste 116, Overland Park, KS 66211
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.

Other Providers at the Same Location NPPES 2

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

MEGAN E CUMMINGS PA-C
Physician Assistant
4601 W 109TH ST STE 116
OVERLAND PARK, KS 66211
Johnson County (913) 469-1115
KATHERINE ROSE DUKE APRN
Nurse Practitioner (Family)
4601 W 109TH ST STE 116
OVERLAND PARK, KS 66211
Johnson County (913) 469-1115

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 Adult And Pediatric Dermatology's NPI number?

The NPI number for Adult And Pediatric Dermatology is 1609966753. It was assigned to this organization in the NPPES registry on October 12, 2006.

Where is Adult And Pediatric Dermatology located?

Adult And Pediatric Dermatology is located at 4601 W 109th St Ste 116, Overland Park, KS 66211. The listed phone number is (913) 469-1115.

What is Adult And Pediatric Dermatology's specialty?

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

Does Adult And Pediatric Dermatology hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 17D0687168) is associated with this NPI, valid through August 31, 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 Adult And Pediatric Dermatology was last updated on July 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.