Rolla Dermatology LLC
NPI 1619714425 · Medical Physician Assistant · Rolla, MO
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Rolla Dermatology LLC is a Medical Physician Assistant organization in Rolla, MO (NPI 1619714425).
Provider details
- NPI number
- 1619714425
- Entity type
- Organization
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Darrin Taylor, Manager(417) 766-2043
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
1 yr 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
- 2024-07-09
- Last updated
- 2024-07-22
- Certified
- 2024-07-22
Frequently asked questions
- What is Rolla Dermatology LLC's NPI number?
- Rolla Dermatology LLC's National Provider Identifier (NPI) is 1619714425, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Rolla Dermatology LLC?
- Rolla Dermatology LLC is classified in the NPPES registry as Medical Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Rolla Dermatology LLC located?
- Rolla Dermatology LLC's practice location on file with NPPES is 1312 E State Hwy 72, Rolla, MO 65401-3939.
- What is Rolla Dermatology LLC's phone number?
- The practice phone number listed in the NPPES registry for Rolla Dermatology LLC is (573) 426-4112.
- Does Rolla Dermatology LLC accept Medicare?
- Rolla 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 Rolla Dermatology LLC?
- The authorized official listed on Rolla Dermatology LLC's NPPES record is Darrin Taylor, Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Rolla Dermatology LLC's NPI active?
- Yes — Rolla Dermatology LLC's NPI (1619714425) is active in the NPPES registry as of the last update on 2024-07-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.