Rolla Dermatology LLC
NPI 1619714425ActiveOrganization· Physician Assistant, Medical· Rolla, MO
Physician Assistant, Medical in Rolla, Missouri, registered in NPPES in July 2024. The authorized official on file is Darrin Taylor, PA-C, Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1619714425 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 9, 2024 |
| Last updated in NPPES | Jul 22, 2024 |
| Certified by provider | Jul 22, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Medical Primary | 363AM0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MO) |
|---|
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