Divine Dermatology and Surgical Institute, PLLC
NPI 1104452804ActiveOrganization· Dermatology· Loveland, CO
Dermatology in Loveland, Colorado, registered in NPPES in March 2020, part of Divine Dermatology and Surgical Institute, PLLC. The authorized official on file is Jennifer Michelle Divine, Owner.
Overview
| NPI | 1104452804 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Divine Dermatology and Surgical Institute, PLLC |
| NPI issued | Mar 14, 2020 |
| Last updated in NPPES | Mar 14, 2020 |
| Certified by provider | Mar 14, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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