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SOUTHWEST SKIN AND CANCER LLC
NPI 1619929783
Specialist in St George, UT

Active since May 17, 2006
383 S 300 E, ST GEORGE, UT 84770(435) 628-2826(435) 628-2839 Get Directions Write a Review

NPPES record last updated: February 14, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Southwest Skin And Cancer Llc NPPES

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

SOUTHWEST SKIN AND CANCER LLC (NPI 1619929783) is a healthcare organization registered as a specialist in St George, Utah and active in the NPI registry since May 2006. The organization maintains a secondary practice location in St George and lists W Bret Smith, Partner And Owner, as its authorized official.

NPPES Registry Identity

NPI1619929783
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameSOUTHWEST SKIN AND CANCER LLC
Location Address383 S 300 ESt George, UT 84770-3620
Mailing Address383 S 300 ESt George, UT 84770-3620 · (435) 628-2826 · Fax (435) 628-2839
Phone(435) 628-2826
Fax(435) 628-2839
Organization SubpartNo
Authorized OfficialW Bret SmithPartner And Owner · (435) 628-2826
Enumeration DateMay 17, 2006
Last NPPES UpdateFebruary 14, 2024
NPPES CertifiedFebruary 13, 2024
✔ NPI 1619929783 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
383 S 300 E, St George, UT 84770
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Secondary Practice Location 1

Location 1254 South 1470 East, 102St George, UT 84790 · Phone (435) 628-2826

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 Molina Healthcare, University of Utah Health Plans.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)

Southwest Skin And Cancer Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Southwest Skin And Cancer LLC, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Bradley Evanson
Dermatology
NPI 1689069312
383 S 300 E
St George, UT 84770
(435) 628-2826
✔ PECOS✔ Accepts MedicareSame address
Greg Jacobsen, M.D.
Dermatology
NPI 1811105745
383 S 300 E
St George, UT 84770
(435) 628-2826
✔ PECOS✔ Accepts MedicareSame address
Wallace Smith, MD
Dermatology
NPI 1164499836
383 S 300 E
St George, UT 84770
(435) 628-2826
✔ PECOSSame address
Wallace Smith, M.D.
Dermatology
NPI 1376800532
383 S 300 E
St George, UT 84770
(435) 628-2826
✔ PECOS✔ Accepts MedicareSame address

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 46D0525866

Southwest Skin And Cancer · St George, UT
Expired · Sep 30, 2026
CLIA Number46D0525866
Laboratory TypePhysician Office
Certificate Effective DateJuly 19, 2024
Certificate Expiration DateSeptember 30, 2026
Laboratory DirectorGreg R. Jacobsen
Laboratory Phone(435) 628-2826
Laboratory LocationSouthwest Skin And Cancer383 S 300 E, St George, UT 84770
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.

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 Southwest Skin And Cancer LLC's NPI number?

The NPI number for Southwest Skin And Cancer LLC is 1619929783. It was assigned to this organization in the NPPES registry on May 17, 2006.

Where is Southwest Skin And Cancer LLC located?

Southwest Skin And Cancer LLC is located at 383 S 300 E, St George, UT 84770. The listed phone number is (435) 628-2826.

What is Southwest Skin And Cancer LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Southwest Skin And Cancer LLC enrolled in Medicare?

Yes. Southwest Skin And Cancer LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southwest Skin And Cancer LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Dermatology, reassign their Medicare billing to Southwest Skin And Cancer LLC. 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, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Southwest Skin And Cancer LLC accept?

Health plans from Molina Healthcare and University of Utah Health Plans list Southwest Skin And Cancer 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 Southwest Skin And Cancer LLC was last updated on February 14, 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.