Destination Dermatology LLC
NPI 1205368453 · Medical Specialty Clinic/Center · Frisco, CO
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Destination Dermatology LLC is a Medical Specialty Clinic/Center organization in Frisco, CO (NPI 1205368453).
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
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
Mailing address
Other names (DBA / former)
- Doing business as
- Renew Dermatology
Registry dates
- Enumerated
- 2017-03-28
- Last updated
- 2017-03-28
Frequently asked questions
- What is Destination Dermatology LLC's NPI number?
- Destination Dermatology LLC's National Provider Identifier (NPI) is 1205368453, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Destination Dermatology LLC?
- Destination Dermatology LLC is classified in the NPPES registry as Medical Specialty Clinic/Center (Ambulatory Health Care Facilities).
- Where is Destination Dermatology LLC located?
- Destination Dermatology LLC's practice location on file with NPPES is 60 Main Street, Frisco, CO 80443.
- What is Destination Dermatology LLC's phone number?
- The practice phone number listed in the NPPES registry for Destination Dermatology LLC is (309) 287-1909.
- Does Destination Dermatology LLC accept Medicare?
- Destination Dermatology LLC 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 Destination Dermatology LLC?
- The authorized official listed on Destination Dermatology LLC's NPPES record is Kelly Ballou, Managing Member. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Destination Dermatology LLC's NPI active?
- Yes — Destination Dermatology LLC's NPI (1205368453) is active in the NPPES registry as of the last update on 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.