DR. TIMOTHY KENT CRAGUN (NPI# 1760419881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760419881 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY KENT CRAGUN |
| Credential | DO |
| Practice Address |
4700 Las Vegas Blvd N Nellis Afb NV 89191-6600 |
| Mailing Address |
2327 Winding Vw San Antonio TX 78260-7263 |
| Practice Telephone | 7023483245 |
| Mailing Telephone | 7025824830 |
| Mailing Fax Number | 2106156793 |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2019-11-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | DO1722 | NV | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 01054132A | IN | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | H0063845 | MD | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 01054132A | IN | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | H0063845 | MD | Allopathic & Osteopathic Physicians |
| Street Address |
4700 LAS VEGAS BLVD N |
| City | NELLIS AFB |
| State | NV |
| Zip Code | 89191-6600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366445389 | Frank J Andriola | Internal Medicine | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2005-05-23 |
| 1245837392 | Cameron Springer | Military Health Care Provider | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2020-10-01 |
| 1063026474 | Haley Suzanne Emery | Physician Assistant | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2020-09-02 |
| 1033729991 | Brock Shaw | Dentist | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2020-08-05 |
| 1801404397 | Madelyn Danielle Golden | Military Health Care Provider | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2020-07-21 |
| 1114544103 | Jami Myong Reece | Family Medicine | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2020-06-25 |
| 1225654296 | Leah Corr | Physician Assistant | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2020-06-24 |
| 1821614405 | Aubrey Amanda Blanchette | Student in an Organized Health Care Education/Training Program | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2020-06-19 |
| 1346866290 | Shelbi Diane Duncan | Physician Assistant | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2020-06-17 |
| 1235751538 | Howard Luong | Physician Assistant | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2020-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225662687 | Ashley Raye Roth-garcia | Student in an Organized Health Care Education/Training Program | 99th Medical Group 4700 Las Vegas Blvd North, Nellis Afb, NV 89191 | 2020-02-25 |
| 1427553734 | Christopher Robert Weisgarber | Student in an Organized Health Care Education/Training Program | Mike O'callaghan Military Medical Center, 4700 Las Vegas Blvd North Bldg 1300, Las Vegas, NV 89191 | 2018-03-28 |
| 1912345448 | Austin Joseph Ladner | Dentist | 99th Air Base Wing Public Affairs, Fpo, AA 89191 | 2013-06-06 |
| 1528329018 | Mayer M Jeppson | Psychologist | 4700 Las Vegas Blvd. N, Nellis Afb, NV 89191 | 2012-05-31 |
| 1255560462 | Jordan Lawrence | Military Health Care Provider | 1579 Malmstrom Avenue, Nellis Afb, NV 89191 | 2009-07-09 |
| 1225263072 | Adrienne L Clark | Military Health Care Provider | 5154 Ellsworth Ave, Suite 61690, Las Vegas, NV 89191 | 2009-05-22 |
| 1568634335 | Eleanor C Basilio | Registered Nurse | 4700 Las Vegas Blvd., Nellis Afb, NV 89191 | 2008-04-01 |
| 1316137037 | Sarah Rachel Glick | Pediatrics | 4700 N. Las Vegas Blvd., Mike O'callaghan Federal Medical Center, 99 Mdos/sgoc, Nellis Afb, NV 89191 | 2007-07-30 |
| 1619181302 | Ben Carter Robinson | Orthopaedic Surgery | 4700 N. Las Vegas Blvd, Nellis Afb-mofh Nellis Orthopedics, Las Vegas, NV 89191 | 2007-05-10 |
| 1609992205 | Conrad Lochner IIi, Odpc | Optometrist | 5691 Rickenbacker Road, Bldg. 431, Las Vegas, NV 89191 | 2007-03-22 |
| Find all providers in zip 89191 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801238852 | Amanda R Leach | Dermatology | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2013-07-18 |
| 1396086377 | Jane H Kerford | Dermatology | 4700 Las Vegas Blvd N, Nellis Afb, NV 89191-6600 | 2013-03-15 |
| 1013160563 | Pamela Landsteiner | Dermatology | 4700 Las Vegas Blvd N Bldg 1300, Dermatology Clinic, Nellis Afb, NV 89191-6600 | 2008-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336773373 | Tck Islay, Inc | Dermatology | 1624 10th St Ste 1, Minden, NV 89423-4477 | 2020-02-28 |
| 1538708573 | Skin Docs | Dermatology | 410 S Rancho Dr, Las Vegas, NV 89106-4802 | 2019-12-21 |
| 1609358886 | Jdr Dermatology Research, LLC. | Dermatology | 9080 W Post Rd Ste 100, Las Vegas, NV 89148 | 2018-09-04 |
| 1003310368 | Lenore S Kakita Md LLC | Dermatology | 9360 W Flamingo Rd Ste 110-325, Las Vegas, NV 89147-6410 | 2018-03-21 |
| 1619492378 | Fife Dermatology, PC 1 | Dermatology | 10080 West Alta Drive, Suite 120, Las Vegas, NV 89145-8651 | 2017-08-03 |
| 1194268987 | J H Daulat Do PC | Dermatology | 1875 S Nellis Blvd, Las Vegas, NV 89104-6215 | 2016-11-28 |
| 1396192761 | Craig Parson | Dermatology | 6850 N Durango Dr Ste 100, Las Vegas, NV 89149-4596 | 2016-05-16 |
| 1912349408 | Cyril M. Joseph | Dermatology | 1470 E Calvada Blvd Ste 600, Pahrump, NV 89048-3906 | 2013-07-24 |
| 1942565205 | Centennial Dermatology and Skin Cancer Inc | Dermatology | 5500 Painted Mirage Road, Suite 100, Las Vegas, NV 89149 | 2012-07-11 |
| 1649543463 | Aaron William Mccook | Dermatology | 340 Falcon Ridge Pkwy Ste 202, Mesquite, NV 89027-8851 | 2012-02-10 |
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| City | NELLIS AFB |
| Zip Code | 89191 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.