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BAYOU DERMATOLOGY LLC
NPI 1699636571
Dermatology in Ruston, LA

Active since November 20, 2025CLIA Certified · 2 labs
911 TECH DR, RUSTON, LA 71270(318) 265-6376(318) 265-6377 Get Directions Write a Review

NPPES record last updated: November 20, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Bayou Dermatology Llc NPPES

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

BAYOU DERMATOLOGY LLC (NPI 1699636571) is a healthcare organization registered as a dermatology in Ruston, Louisiana and active in the NPI registry since November 2025. The organization holds 2 active CLIA laboratory certificates and lists Joshua Mandrell, Owner/md, as its authorized official.

NPPES Registry Identity

NPI1699636571
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameBAYOU DERMATOLOGY LLC
Location Address911 TECH DRRuston, LA 71270-0701
Mailing Address911 Tech DrRuston, LA 71270-0701 · (318) 265-6376 · Fax (318) 265-6377
Phone(318) 265-6376
Fax(318) 265-6377
Organization SubpartNo
Authorized OfficialJoshua MandrellOwner/md · (318) 265-6376
Enumeration DateNovember 20, 2025
NPPES CertifiedNovember 20, 2025
✔ NPI 1699636571 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.
911 TECH DR, Ruston, LA 71270
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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

CLIA Laboratory Certificates CMS CLIA 2

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 19D2335633

Bayou Dermatology Mohs Laboratory · Ruston, LA
Active · expires Dec 14, 2027
CLIA Number19D2335633
Laboratory TypePhysician Office
Certificate Effective DateDecember 15, 2025
Certificate Expiration DateDecember 14, 2027
Laboratory DirectorJoshua C. Mandrell
Laboratory Phone(318) 265-6376
Laboratory LocationBayou Dermatology Mohs Laboratory911 Tech Drive, Ruston, LA 71270
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 Waiver 19D2335632

Bayou Dermatology · Minden, LA
Active · expires Dec 14, 2027
CLIA Number19D2335632
Laboratory TypePhysician Office
Certificate Effective DateDecember 15, 2025
Certificate Expiration DateDecember 14, 2027
Laboratory DirectorJoshua Mandrell
Laboratory Phone(318) 265-6376
Laboratory LocationBayou Dermatology3 Medical Plaza Place, Minden, LA 71055
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

LINZIE L HEBERT PA-C
Physician Assistant (Medical)
911 TECH DR
RUSTON, LA 71270
Lincoln Parish (318) 265-6376
DR. JOSHUA CALEB MANDRELL M.D.
Dermatology
911 TECH DR
RUSTON, LA 71270
Lincoln Parish (318) 265-6376
DR. JIMMY N EATON O.D.
Optometrist
911 TECH DR
RUSTON, LA 71270
Lincoln Parish (318) 251-9095
GARRETT PRICE SOILEAU PA-C
Physician Assistant
911 TECH DR
RUSTON, LA 71270
Lincoln Parish (318) 265-6376

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 Bayou Dermatology LLC's NPI number?

The NPI number for Bayou Dermatology LLC is 1699636571. It was assigned to this organization in the NPPES registry on November 20, 2025.

Where is Bayou Dermatology LLC located?

Bayou Dermatology LLC is located at 911 Tech Dr, Ruston, LA 71270. The listed phone number is (318) 265-6376.

What is Bayou Dermatology LLC's specialty?

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

Does Bayou Dermatology LLC hold CLIA laboratory certificates?

Yes. 2 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.

When was this NPI record last updated?

The NPPES record for Bayou Dermatology LLC was last updated on November 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.