DRAPER DERMATOLOGY, P.C. (NPI# 1942832159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942832159 |
| Entity Type | Organization |
| Organization Name | DRAPER DERMATOLOGY, P.C. |
| Practice Address |
196 Arrowhead Dr Ste 7 Evanston WY 82930-8752 |
| Mailing Address |
1325 W South Jordan Pkwy Ste 103 South Jordan UT 84095-9060 |
| Practice Telephone | 8012326556 |
| Practice Fax Number | 8019878467 |
| Mailing Telephone | 8012326556 |
| Mailing Fax Number | 8019878467 |
| Enumeration Date | 2020-02-05 |
| Last Update Date | 2020-03-05 |
| Authorized Official Name | RYAN COOKSEY (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 8012326556 |
| Is Organization Subpart | Y |
| Parent Organization Name | DRAPER DERMATOLOGY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 154374100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093224818 | Draper Dermatology, P.C. | Dermatology | 1325 W South Jordan Pkwy Ste 103, South Jordan, UT 84095-9060 | 2017-09-25 |
| Street Address |
196 ARROWHEAD DR STE 7 |
| City | EVANSTON |
| State | WY |
| Zip Code | 82930-8752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598398935 | Colby Kim Gomez | Physical Therapist | 190 Arrowhead Dr, Evanston, Wy 82930, Evanston, WY 82930 | 2020-02-13 |
| 1164808382 | Marilyn Carol Edgeworth Tacoma | Registered Nurse | 1037 Morse Lee St, Evanston, WY 82930 | 2015-08-11 |
| 1699159723 | Impact Physical Therapy LLC | Clinic/Center | 96 Yellow Creek Road, Evanston, WY 82930 | 2015-07-18 |
| 1578942421 | Mark Carstensen | Case Manager/Care Coordinator | 219 7th Street, Evanston, WY 82930 | 2015-05-26 |
| 1013396241 | Jennifer Carstensen | Case Manager/Care Coordinator | 325 Arrowhead Drive, Evanston, WY 82930 | 2015-05-20 |
| 1780083782 | Christa Lena Barker | Nurse Practitioner | 191 Overthrust Road, Evanston, WY 82930 | 2014-08-15 |
| 1366865339 | Don Mckay Francom | Dentist | 170 Arrowhead Dr. Suite 1, Evanston, WY 82930 | 2014-01-28 |
| 1417228370 | Premier Surgical Center, LLC | Clinic/Center | 195 Overthrust Road, Evanston, WY 82930 | 2012-01-24 |
| 1588959324 | Mejia D Williams | Social Worker | 190 Overthrust Road, Evanston, WY 82930 | 2011-06-09 |
| 1225327000 | Richard Jay Capener | Family Medicine | 196 Arrowhead Dr Ste 1, Evanston, WY 82930 | 2011-04-01 |
| Find all providers in zip 82930 | ||||
| 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 |
|---|---|---|---|---|
| 1578721353 | Lynne R. Eramo | Dermatology | 414 Church St, Evanston, IL 60201-4514 | 2008-05-28 |
| 1538225560 | Lawrence E Levine | Dermatology | 800 Austin East Tower #460, Evanston, IL 60202 | 2006-12-27 |
| 1043383524 | Tony S. Fu | Dermatology | 636 Church St Ste 222, Evanston, IL 60201-4578 | 2006-11-15 |
| 1447248752 | Leonard Levitt | Dermatology | 1101 Howard St, Ste 204, Evanston, IL 60202-3878 | 2005-10-11 |
| 1093246621 | Arjun Dayal | Dermatology | 2650 Ridge Ave, Evanston, IL 60201 | 2017-03-24 |
| 1205063781 | Jill Christina Anderson | Dermatology | 1704 Maple Ave, Suite 200, Evanston, IL 60201-3134 | 2009-06-11 |
| 1568656130 | Madhuri V Konanahalli | Dermatology | 1000 Central St Ste 800, Evanston, IL 60201 | 2007-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427408319 | Advanced Dermatology of Wyoming, Inc | Dermatology | 62 South Redmond Street, Jackson, WY 83001-8664 | 2016-06-21 |
| 1629210992 | Matthew Reed Green | Dermatology | 2546 E 2nd St., #400, Casper, WY 82609 | 2009-04-01 |
| 1265653745 | Brittany Wilson Baker | Dermatology | 984 W Broadway, Suite 4, Jackson, WY 83001-0000 | 2007-05-01 |
| 1952317505 | Scott D Bennion | Dermatology | 2546 E 2nd St Ste 400, Casper, WY 82609-2062 | 2006-08-01 |
| 1821041856 | Thomas J Hogarty, M.d. | Dermatology | 206 N Brooks St, Sheridan, WY 82801-3801 | 2006-05-19 |
| 1790749836 | Christopher Michael Lowther | Dermatology | 802 Gerrans Ave, Cody, WY 82414-4120 | 2006-04-14 |
| 1699742957 | Sandra K Surbrugg | Dermatology | 123 Western Hills Blvd, Cheyenne, WY 82009-3446 | 2006-03-07 |
| 1447233754 | Jonathan Glenn Baker | Dermatology | 984 West Broadway, Suite 4, Jackson, WY 83001-0000 | 2005-11-22 |
| 1700389004 | Tyler L. Quest, M.d., P.C. | Dermatology | 1119 E 3rd St, Casper, WY 82601-2905 | 2018-03-13 |
| 1043630619 | Krystal J Massey | Dermatology | 123 Western Hills Blvd, Cheyenne, WY 82009-3446 | 2014-04-23 |
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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.