LP Derm LLC
NPI 1538875786ActiveOrganization· Dermatology· Providence, UT
Dermatology in Providence, Utah, registered in NPPES in January 2023, part of LP Derm LLC. The authorized official on file is Cory B. Maughan, DO, Owner. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1538875786 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | LP Derm LLC |
| NPI issued | Jan 30, 2023 |
| Last updated in NPPES | Jan 30, 2023 |
| Certified by provider | Jan 30, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
| Dermatology, MOHS-Micrographic Surgery | 207ND0101X | — | — |
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) | Enrolled Part B Supplier - Clinic/Group Practice (ID); Part B Supplier - Clinic/Group Practice (UT) |
|---|
Other Dermatology providers in Providence
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- 1568029957
- 1477818920