Jordan Valley Dermatology
NPI 1073954913ActiveOrganization· Specialist· Casper, WY
Specialist in Casper, Wyoming, registered in NPPES in July 2013. The authorized official on file is Virginia Louise Tubbs, NP, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1073954913 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 8, 2013 |
| Last updated in NPPES | Jun 21, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist Primary | 174400000X | 8624096-4405 | UT |
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 (WY) |
|---|
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