DERMATOLOGY ASSOCIATES LLC
NPI 1750590923
Nurse Practitioner in Jackson, TN
NPI Status: Active since May 22, 2007
Contact Information
2817 N HIGHLAND AVE
SUITE A
JACKSON, TN
ZIP 38305
Phone: (731) 661-0061
Fax: (731) 661-9107
- Organization
- Nurse Practitioner
- CLIA Number: 44D2171640
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-04-2026
About DERMATOLOGY ASSOCIATES LLC
This page provides the complete NPI Profile along with additional information for Dermatology Associates Llc, a provider established in Jackson, Tennessee operating as a Nurse Practitioner. The healthcare provider is registered in the NPI registry with number 1750590923 assigned on May 2007. The practitioner's primary taxonomy code is 363L00000X with license number APN 000 000 8039 (TN). The provider is registered as an organization and their NPI record was last updated 17 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Ms. Patricia Craig Booher Nurse Practitioner (Owner)
- NPI
- 1750590923
- Provider Name
- DERMATOLOGY ASSOCIATES LLC
- Entity Type
- Organization
- Location Address
- 2817 N HIGHLAND AVE SUITE A JACKSON, TN 38305
- Location Phone
- (731) 661-0061
- Location Fax
- (731) 661-9107
- Mailing Address
- 2817 N HIGHLAND AVE SUITE A JACKSON, TN 38305
- Mailing Phone
- (731) 661-0061
- Mailing Fax
- (731) 661-9107
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-22-2007
- Last Update Date
- 03-04-2008
- Code Navigator
A nurse practitioner (NP) like Dermatology Associates Llc is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner
- Taxonomy Code
- 363L00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- APN 000 000 8039
- License State
- TN
- Taxonomy Description
- (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3370114 | MEDICAID (05) | TN | |
| 7587201 | OTHER (01) | AETNA | |
| 4165097 | OTHER (01) | TN | BLUE CROSS BLUE SHIELD |
| 3370114 | MEDICARE PIN (08) | TN |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 44D2171640
- Facility Type
- Physician Office
- Certificate Effective Date
- February 05, 2024
- Certificate Expiration Date
- February 04, 2026
- Laboratory Director
- DR. DAFNIS C. CARRANZA
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Dermatology Associates Llc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 5 | 0 | 5 | 9 | 0 | 9 | 2 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 10 | 0 | 10 | 9 | 0 | 9 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 0 + 0 + 1 + 0 + 9 + 0 + 9 + 4 + 24 = 57 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 57 = 3 | 3 | ||||||||
The NPI number 1750590923 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1750590923, enumerated in the NPI registry as an "organization" on May 22, 2007
The provider is located at 2817 N Highland Ave Suite A Jackson, Tn 38305 and the phone number is (731) 661-0061
This medical organization specializes in Nurse Practitioner with taxonomy code 363L00000X
The provider might be accepting Accepts: Medicare, Medicaid, Aetna and Blue Cross Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 44D2171640 for a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on May 22, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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