Integrated Dermatology of Northeast Missouri LLC
NPI 1992518658 · Dermatology Physician · Hannibal, MO
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Integrated Dermatology of Northeast Missouri LLC is a Dermatology Physician organization in Hannibal, MO (NPI 1992518658).
Provider details
- NPI number
- 1992518658
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jeffrey Queen, Authorized Official(561) 231-2635
Specialties & taxonomies
Allopathic & Osteopathic Physicians
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
Other names (DBA / former)
- Former legal business name
- Integrated Dermatology of Northeast Missouri LLC
Registry dates
- Enumerated
- 2025-01-28
- Last updated
- 2025-01-28
- Certified
- 2025-01-28
Frequently asked questions
- What is Integrated Dermatology of Northeast Missouri LLC's NPI number?
- Integrated Dermatology of Northeast Missouri LLC's National Provider Identifier (NPI) is 1992518658, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Integrated Dermatology of Northeast Missouri LLC?
- Integrated Dermatology of Northeast Missouri LLC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Integrated Dermatology of Northeast Missouri LLC located?
- Integrated Dermatology of Northeast Missouri LLC's practice location on file with NPPES is 163 Medical Dr, Hannibal, MO 63401-6884.
- What is Integrated Dermatology of Northeast Missouri LLC's phone number?
- The practice phone number listed in the NPPES registry for Integrated Dermatology of Northeast Missouri LLC is (573) 719-1818.
- Does Integrated Dermatology of Northeast Missouri LLC accept Medicare?
- Integrated Dermatology of Northeast Missouri 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 Integrated Dermatology of Northeast Missouri LLC?
- The authorized official listed on Integrated Dermatology of Northeast Missouri LLC's NPPES record is Jeffrey Queen, Authorized Official. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Integrated Dermatology of Northeast Missouri LLC's NPI active?
- Yes — Integrated Dermatology of Northeast Missouri LLC's NPI (1992518658) is active in the NPPES registry as of the last update on 2025-01-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.