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INTEGRATED DERMATOLOGY OF BOUNTIFUL LLC
NPI 1629396841
Dermatology in Centerville, UT

Active since May 12, 2010CLIA 46D0674625 · Certificate of Compliance
1222 W LEGACY CROSSING BLVD STE 200, CENTERVILLE, UT 84014(801) 298-3802 Get Directions Write a Review

NPPES record last updated: January 15, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Integrated Dermatology Of Bountiful Llc NPPES

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

INTEGRATED DERMATOLOGY OF BOUNTIFUL LLC (NPI 1629396841) is a healthcare organization registered as a dermatology in Centerville, Utah and active in the NPI registry since May 2010. The organization holds a CLIA Certificate of Compliance certificate valid through November 5, 2026 and lists Adam S. Plotkin, Owner, as its authorized official.

NPPES Registry Identity

NPI1629396841
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameINTEGRATED DERMATOLOGY OF BOUNTIFUL LLC
Location Address1222 W LEGACY CROSSING BLVD STE 200Centerville, UT 84014-5560
Mailing Address4700 Exchange Ct Ste 110Boca Raton, FL 33431-4450 · (561) 314-2000
Phone(801) 298-3802
Organization SubpartNo
Authorized OfficialAdam S. PlotkinOwner · (561) 314-2000
Enumeration DateMay 12, 2010
Last NPPES UpdateJanuary 15, 2019
✔ NPI 1629396841 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.
1222 W LEGACY CROSSING BLVD STE 200, Centerville, UT 84014
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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 BridgeSpan Health Company, Regence BlueCross BlueShield of Utah, 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)

Integrated Dermatology Of Bountiful Llc 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 Integrated Dermatology Of Bountiful LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Marian Bridenstine, RN, FNP
Nurse Practitioner
NPI 1043836679
1222 W LEGACY CROSSING BLVD STE 200
Centerville, UT 84014
(801) 298-3802
✔ PECOS✔ Accepts MedicareSame address
Amy Curtis, MD
Dermatology
NPI 1841499084
425 MEDICAL DR SUITE 218
Bountiful, UT 84010
(801) 298-3802
✔ PECOS✔ Accepts Medicare2.7 mi
Jill Mckenzie, MD
Micrographic Dermatologic Surgery (MDS)
NPI 1154513661
1100 S DOBSON RD 223
Chandler, AZ 85286
(480) 821-8888
✔ PECOS✔ Accepts Medicare526 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

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 46D0674625

Integrated Dermatology Of Bountiful · Centerville, UT
Active · expires Nov 5, 2026
CLIA Number46D0674625
Laboratory TypeIndependent
Certificate Effective DateNovember 6, 2024
Certificate Expiration DateNovember 5, 2026
Laboratory DirectorAmy Curtis
Laboratory Phone(801) 298-3802
Laboratory LocationIntegrated Dermatology Of Bountiful1222 West Legacy Crossing Boulevard, Suite 200, Centerville, UT 84014
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 Integrated Dermatology Of Bountiful LLC's NPI number?

The NPI number for Integrated Dermatology Of Bountiful LLC is 1629396841. It was assigned to this organization in the NPPES registry on May 12, 2010.

Where is Integrated Dermatology Of Bountiful LLC located?

Integrated Dermatology Of Bountiful LLC is located at 1222 W Legacy Crossing Blvd Ste 200, Centerville, UT 84014. The listed phone number is (801) 298-3802.

What is Integrated Dermatology Of Bountiful LLC's specialty?

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

Is Integrated Dermatology Of Bountiful LLC enrolled in Medicare?

Yes. Integrated Dermatology Of Bountiful LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Integrated Dermatology Of Bountiful LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Integrated Dermatology Of Bountiful LLC, in Dermatology, Micrographic Dermatologic Surgery (MDS) 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 and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Integrated Dermatology Of Bountiful LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 46D0674625) is associated with this NPI, valid through November 5, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Integrated Dermatology Of Bountiful LLC accept?

Health plans from BridgeSpan Health Company, Regence BlueCross BlueShield of Utah and University of Utah Health Plans list Integrated Dermatology Of Bountiful 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 Integrated Dermatology Of Bountiful LLC was last updated on January 15, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.