Skin Dermatology Practitioner, PLLC
NPI 1003505389ActiveOrganization· Nurse Practitioner· Jonesboro, AR
Nurse Practitioner in Jonesboro, Arkansas, registered in NPPES in May 2023. The authorized official on file is Nancy Pemberton, NP, Authorized Official. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1003505389 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 3, 2023 |
| Last updated in NPPES | Jun 21, 2023 |
| Certified by provider | Jun 21, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AR) |
|---|
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