Advanced Dermatology of Wyoming, Inc
NPI 1427408319ActiveOrganization· Dermatology· Jackson, WY
Dermatology in Jackson, Wyoming, registered in NPPES in June 2016. The authorized official on file is Linda Crandall, Credentialing Coordinator. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1427408319 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 21, 2016 |
| Last updated in NPPES | Oct 6, 2016 |
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 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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