Spring Derm, LLC
NPI 1770196719ActiveOrganization· Physician Assistant· Branson, MO
Physician Assistant in Branson, Missouri, registered in NPPES in August 2020, part of Spring Derm, LLC. The authorized official on file is Deborah Householder, Billing/Credentialing Manager.
Overview
| NPI | 1770196719 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Spring Derm, LLC |
| NPI issued | Aug 28, 2020 |
| Last updated in NPPES | Aug 28, 2020 |
| Certified by provider | Aug 28, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | — | — |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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