Skin Dermatology Practitioner, PLLC
NPI 1003505389 · Nurse Practitioner · Jonesboro, AR
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Skin Dermatology Practitioner, PLLC is a Nurse Practitioner organization in Jonesboro, AR (NPI 1003505389).
Provider details
- NPI number
- 1003505389
- Entity type
- Organization
- Primary specialty
- Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Nancy Pemberton, Authorized Official(708) 530-2453
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2023-05-03
- Last updated
- 2023-06-21
- Certified
- 2023-06-21
Frequently asked questions
- What is Skin Dermatology Practitioner, PLLC's NPI number?
- Skin Dermatology Practitioner, PLLC's National Provider Identifier (NPI) is 1003505389, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Skin Dermatology Practitioner, PLLC?
- Skin Dermatology Practitioner, PLLC is classified in the NPPES registry as Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Skin Dermatology Practitioner, PLLC located?
- Skin Dermatology Practitioner, PLLC's practice location on file with NPPES is 3106 Southwest Dr Ste 103, Jonesboro, AR 72404-8404.
- What is Skin Dermatology Practitioner, PLLC's phone number?
- The practice phone number listed in the NPPES registry for Skin Dermatology Practitioner, PLLC is (870) 641-7546.
- Does Skin Dermatology Practitioner, PLLC accept Medicare?
- Skin Dermatology Practitioner, PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Skin Dermatology Practitioner, PLLC?
- The authorized official listed on Skin Dermatology Practitioner, PLLC's NPPES record is Nancy Pemberton, Authorized Official. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Skin Dermatology Practitioner, PLLC's NPI active?
- Yes — Skin Dermatology Practitioner, PLLC's NPI (1003505389) is active in the NPPES registry as of the last update on 2023-06-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.