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MOUNTAIN WEST DERM - BLACKHART PLLC
NPI 1891467577
Dermatology in Roseburg, OR

Active since October 01, 2021
341 NW MEDICAL LOOP STE 110, ROSEBURG, OR 97471(541) 440-2165(541) 440-8932 Get Directions Write a Review

NPPES record last updated: October 4, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 4, 2021, Oct 1, 2021 (2 updates tracked since 2021).

About Mountain West Derm - Blackhart Pllc NPPES

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

MOUNTAIN WEST DERM - BLACKHART PLLC (NPI 1891467577) is a healthcare organization registered as a dermatology in Roseburg, Oregon and active in the NPI registry since October 2021. The organization lists Jeffrey B Shackelton, Owner, as its authorized official.

NPPES Registry Identity

NPI1891467577
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameMOUNTAIN WEST DERM - BLACKHART PLLC
Location Address341 NW MEDICAL LOOP STE 110Roseburg, OR 97471-5546
Mailing Address341 Nw Medical Loop Ste 110Roseburg, OR 97471-5546
Phone(541) 440-2165
Fax(541) 440-8932
Organization SubpartNo
Authorized OfficialJeffrey B ShackeltonOwner · (775) 283-4086
Enumeration DateOctober 1, 2021
Last NPPES UpdateOctober 4, 20212 updates tracked since enumeration
NPPES CertifiedOctober 4, 2021
✔ NPI 1891467577 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.
341 NW MEDICAL LOOP STE 110, Roseburg, OR 97471
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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

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 Mountain West Derm - Blackhart PLLC's NPI number?

The NPI number for Mountain West Derm - Blackhart PLLC is 1891467577. It was assigned to this organization in the NPPES registry on October 1, 2021.

Where is Mountain West Derm - Blackhart PLLC located?

Mountain West Derm - Blackhart PLLC is located at 341 NW Medical Loop Ste 110, Roseburg, OR 97471. The listed phone number is (541) 440-2165.

What is Mountain West Derm - Blackhart PLLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Mountain West Derm - Blackhart PLLC was last updated on October 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.