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ADVANCED DERMATOLOGY OF COLORADO, PC
NPI 1710370648
Dermatology in Fort Collins, CO

Active since March 17, 2015CLIA 06D1106242 · Accreditation
1100 POUDRE RIVER DR UNIT A, FORT COLLINS, CO 80524(970) 484-6303(970) 484-3036 Get Directions Write a Review

NPPES record last updated: November 6, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Advanced Dermatology Of Colorado, Pc NPPES

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

ADVANCED DERMATOLOGY OF COLORADO, PC (NPI 1710370648) is a healthcare organization registered as a dermatology in Fort Collins, Colorado and active in the NPI registry since March 2015. The organization holds an CLIA Accreditation certificate valid through March 14, 2028 and lists Amy Declue, Director-provider Services, as its authorized official.

NPPES Registry Identity

NPI1710370648
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameADVANCED DERMATOLOGY OF COLORADO, PC
Location Address1100 POUDRE RIVER DR UNIT AFort Collins, CO 80524-3557
Mailing Address151 Southhall Ln, Suite 300Maitland, FL 32751-7176 · (407) 875-2080
Phone(970) 484-6303
Fax(970) 484-3036
Organization SubpartNo
Authorized OfficialAmy DeclueDirector-provider Services · (407) 875-2080
Enumeration DateMarch 17, 2015
Last NPPES UpdateNovember 6, 2018
✔ NPI 1710370648 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.
1100 POUDRE RIVER DR UNIT A, Fort Collins, CO 80524
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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

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 Accreditation 06D1106242

Advanced Dermatology Of Colorado · Fort Collins, CO
Active · expires Mar 14, 2028
CLIA Number06D1106242
Laboratory TypePhysician Office
Certificate Effective DateMarch 15, 2026
Certificate Expiration DateMarch 14, 2028
Laboratory DirectorDr. Etan A. Marks
Laboratory Phone(970) 484-3078
Laboratory LocationAdvanced Dermatology Of Colorado1100 Poudre River Dr, Fort Collins, CO 80524
CLIA data matches this NPI record on: Address Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 2

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

DR. RICHARD THOMAS ETHRIDGE MD
Surgery (Plastic and Reconstructive Surgery)
1100 POUDRE RIVER DR UNIT A
FORT COLLINS, CO 80524
Larimer County (970) 484-6303
DR. KATHERINE SUE MESSNER DO
Pathology (Anatomic Pathology & Clinical Pathology)
1100 POUDRE RIVER DR UNIT A
FORT COLLINS, CO 80524
Larimer County (970) 484-3078

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 Advanced Dermatology Of Colorado, PC's NPI number?

The NPI number for Advanced Dermatology Of Colorado, PC is 1710370648. It was assigned to this organization in the NPPES registry on March 17, 2015.

Where is Advanced Dermatology Of Colorado, PC located?

Advanced Dermatology Of Colorado, PC is located at 1100 Poudre River Dr Unit A, Fort Collins, CO 80524. The listed phone number is (970) 484-6303.

What is Advanced Dermatology Of Colorado, PC's specialty?

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

Does Advanced Dermatology Of Colorado, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 06D1106242) is associated with this NPI, valid through March 14, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Advanced Dermatology Of Colorado, PC was last updated on November 6, 2018. 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.