ROLLA DERMATOLOGY LLC
NPI 1619714425
Physician Assistant - Medical in Rolla, MO

Q: What is Rolla Dermatology LLC's NPI number?

The NPI number for Rolla Dermatology LLC is 1619714425. It was assigned to this organization in the NPPES registry on July 9, 2024.

Q: What is Rolla Dermatology LLC's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Active since July 09, 2024

1312 E STATE HWY 72, ROLLA, MO 65401(573) 426-4112 Get Directions Write a Review

NPPES record last updated: July 22, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 22, 2024, Jul 9, 2024 (2 updates tracked since 2024).

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About Rolla Dermatology Llc NPPES

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

ROLLA DERMATOLOGY LLC (NPI 1619714425) is a healthcare organization registered as a medical in Rolla, Missouri and active in the NPI registry since July 2024. The organization lists Darrin Taylor, Manager, as its authorized official.

NPPES Registry Identity

NPI1619714425

Entity TypeOrganization

Primary Taxonomy363AM0700X

Legal Business NameROLLA DERMATOLOGY LLC

Location Address1312 E STATE HWY 72Rolla, MO 65401-3939

Mailing Address13109 Sterling Hills DrRolla, MO 65401-6644 · (417) 766-2043

Phone(573) 426-4112

Organization SubpartNo

Authorized OfficialDarrin TaylorManager · (417) 766-2043

Enumeration DateJuly 9, 2024

Last NPPES UpdateJuly 22, 20242 updates tracked since enumeration

NPPES CertifiedJuly 22, 2024

✔ NPI 1619714425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

1312 E STATE HWY 72, Rolla, MO 65401

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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 SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

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 Rolla Dermatology LLC's NPI number?

The NPI number for Rolla Dermatology LLC is 1619714425. It was assigned to this organization in the NPPES registry on July 9, 2024.

Where is Rolla Dermatology LLC located?

Rolla Dermatology LLC is located at 1312 E State Hwy 72, Rolla, MO 65401. The listed phone number is (573) 426-4112.

What is Rolla Dermatology LLC's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

What insurance does Rolla Dermatology LLC accept?

Health plans from Anthem Blue Cross and Blue Shield list Rolla Dermatology LLC 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 Rolla Dermatology LLC was last updated on July 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.