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DERMATOLOGY CENTER OF SOUTHERN INDIANA, P.C.
NPI 1659451755
Specialist in Bloomington, IN

Active since October 16, 2006CLIA Certified · 4 labs
1200 S ROGERS ST, BLOOMINGTON, IN 47403(812) 339-6434(812) 331-0196 Get Directions Write a Review

NPPES record last updated: April 11, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dermatology Center Of Southern Indiana, P.c. NPPES

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

DERMATOLOGY CENTER OF SOUTHERN INDIANA, P.C. (NPI 1659451755) is a healthcare organization registered as a specialist in Bloomington, Indiana and active in the NPI registry since October 2006. The organization holds 4 active CLIA laboratory certificates and lists Mary Kathleen Mctigue, President, as its authorized official.

NPPES Registry Identity

NPI1659451755
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameDERMATOLOGY CENTER OF SOUTHERN INDIANA, P.C.
Location Address1200 S ROGERS STBloomington, IN 47403-4792
Mailing Address1200 S Rogers StBloomington, IN 47403-4792 · (812) 339-6434 · Fax (812) 331-0196
Phone(812) 339-6434
Fax(812) 331-0196
Organization SubpartNo
Authorized OfficialMary Kathleen MctiguePresident · (812) 339-6434
Enumeration DateOctober 16, 2006
Last NPPES UpdateApril 11, 2016
✔ NPI 1659451755 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.
1200 S ROGERS ST, Bloomington, IN 47403
Open in Google Maps ↗

Other Identifiers 2

Medicare ID-Type Unspecified562570IN
Medicaid100182850IN

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 Buckeye Health Plan, Ambetter from Meridian, Ambetter Health.Insurance ›

CLIA Laboratory Certificates CMS CLIA 4

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 15D0360649

Dermatology Center Of Southern Indiana PC · Bloomington, IN
Active · expires Dec 2, 2027
CLIA Number15D0360649
Laboratory TypePhysician Office
Certificate Effective DateDecember 3, 2025
Certificate Expiration DateDecember 2, 2027
Laboratory DirectorTalley B. Whang
Laboratory Phone(812) 339-6434
Laboratory LocationDermatology Center Of Southern Indiana PC1200 S Rogers St, Bloomington, IN 47403
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.

Certificate of Compliance 15D2291385

Dermatology Center Of Southern Indiana, PC · Bloomington, IN
Active · expires May 5, 2028
CLIA Number15D2291385
Laboratory TypePhysician Office
Certificate Effective DateMay 6, 2026
Certificate Expiration DateMay 5, 2028
Laboratory DirectorTalley B. Whang
Laboratory Phone(812) 339-6434
Laboratory LocationDermatology Center Of Southern Indiana, PC2114 E Rock Creek Dr, Bloomington, IN 47401
CLIA data matches this NPI record on: 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.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 15D2284989

Dermatology Center Of Southern Indiana, PC · Bedford, IN
Active · expires Jul 2, 2027
CLIA Number15D2284989
Laboratory TypePhysician Office
Certificate Effective DateJuly 3, 2025
Certificate Expiration DateJuly 2, 2027
Laboratory DirectorTalley B. Whang
Laboratory Phone(812) 339-6434
Laboratory LocationDermatology Center Of Southern Indiana, PC1625 O Street, Bedford, IN 47421
CLIA data matches this NPI record on: 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 for Provider-Performed Microscopy Procedures (PPMP) 15D2284991

Dermatology Center Of Southern Indiana PC · New Whiteland, IN
Active · expires Jul 2, 2027
CLIA Number15D2284991
Laboratory TypePhysician Office
Certificate Effective DateJuly 3, 2025
Certificate Expiration DateJuly 2, 2027
Laboratory DirectorTalley B. Whang
Laboratory Phone(812) 339-6434
Laboratory LocationDermatology Center Of Southern Indiana PC340 Tracy Road, New Whiteland, IN 46184
CLIA data matches this NPI record on: 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 15

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

SUSAN D STOLZ NP
Nurse Practitioner
1200 S ROGERS ST
BLOOMINGTON, IN 47403
Monroe County (812) 339-6434
MADISON ELIZABETH MCNEELY PA-C
Physician Assistant
1200 S ROGERS ST
BLOOMINGTON, IN 47403
Monroe County (812) 339-6434
DR. ROXANNE RAJAII D.O.
Dermatology
1200 S ROGERS ST
BLOOMINGTON, IN 47403
Monroe County (812) 339-6434
STACI C MURPHY FNP, PNP
Nurse Practitioner
1200 S ROGERS ST
BLOOMINGTON, IN 47403
Monroe County (812) 339-6434
MANDY D WEVER FNP
Nurse Practitioner
1200 S ROGERS ST
BLOOMINGTON, IN 47403
Monroe County (812) 339-6434
NATALIE HARRELL PA-C
Physician Assistant
1200 S ROGERS ST
BLOOMINGTON, IN 47403
Monroe County (812) 339-6434
DR. MARY KATHLEEN MCTIGUE M.D.
Dermatology
1200 S ROGERS ST
BLOOMINGTON, IN 47403
Monroe County (812) 339-6434
MICHELLE GITA BAECHTOLD MD
Dermatology
1200 S ROGERS ST
BLOOMINGTON, IN 47403
Monroe County (812) 339-6434

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 Dermatology Center Of Southern Indiana, P.C.'s NPI number?

The NPI number for Dermatology Center Of Southern Indiana, P.C. is 1659451755. It was assigned to this organization in the NPPES registry on October 16, 2006.

Where is Dermatology Center Of Southern Indiana, P.C. located?

Dermatology Center Of Southern Indiana, P.C. is located at 1200 S Rogers St, Bloomington, IN 47403. The listed phone number is (812) 339-6434.

What is Dermatology Center Of Southern Indiana, P.C.'s specialty?

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

Does Dermatology Center Of Southern Indiana, P.C. hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Dermatology Center Of Southern Indiana, P.C. accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter from Meridian list Dermatology Center Of Southern Indiana, P.C. 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 Dermatology Center Of Southern Indiana, P.C. was last updated on April 11, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.