Integrated Dermatology of Northeast Missouri LLC
NPI 1992518658ActiveOrganization· Dermatology· Hannibal, MO
Dermatology in Hannibal, Missouri, registered in NPPES in January 2025. The authorized official on file is Jeffrey Queen, Authorized Official. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1992518658 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 28, 2025 |
| Last updated in NPPES | Jan 28, 2025 |
| Certified by provider | Jan 28, 2025 |
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 (MO) |
|---|
Other Dermatology providers in Hannibal
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- 1881673457