OrganizationActive
Destination Dermatology LLC
NPI 1205368453 · Medical Specialty Clinic/Center · Frisco, CO
Provider details
- NPI number
- 1205368453
- Entity type
- Organization
- Primary specialty
- Medical Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kelly Ballou, Managing Member(309) 287-1909
- License
- PA0004388 (CO)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(70/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 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
60 Main Street
Ste F, G & H
Frisco, CO 80443
Phone: (309) 287-1909
Street-level locationGet directions
Mailing address
265 Dillon Ridge Rd
Dillon, CO 80435-6009
Other names (DBA / former)
- Doing business as
- Renew Dermatology
Registry dates
- Enumerated
- 2017-03-28
- Last updated
- 2017-03-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.