JENNIFER M. DIVINE MD – NPI #1063779072
Dermatology

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

JENNIFER DIVINE is a dermatologist located in FORT COLLINS, CO. NPPES has assigned the NPI number 1063779072 to JENNIFER DIVINE on April 15, 2012. It is a Type-1 NPI, indicating this NPI number is associated with an individual. She is also known by her former name JENNIFER MICHELLE CORBIN. The primary taxonomy selected by this provider is 207ND0101X from the Health Care Provider Taxonomy code set, which is classified as Dermatology, specializing in MOHS-Micrographic Surgery

The NPI profile was last updated on Jul 19, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JENNIFER DIVINE below.

NPI Profile for
JENNIFER M. DIVINE

NPI Number
1063779072
Enumeration Date

(more than 14 years ago)
Entity Type
Type-1  Individual (Female)
Legal Name
JENNIFER M. DIVINE
Former Name: JENNIFER MICHELLE CORBIN
Credentials
MD
Primary location
1260 DOCTOR'S LANE
FORT COLLINS, CO 80524
Phone: (970) 286-2668 Fax: (970) 294-4954
Mailing address
Same as primary location
Sole Proprietor
Yes
Updated
Certification Date
Jul 19, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207ND0101X
- Dermatology / MOHS-Micrographic Surgery (Primary)
FL ME 131766

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Additional Information

Education
UNIVERSITY OF SOUTH FLORIDA COLLEGE OF MEDICINE - Graduated 2012
Accepts Medicare
This provider accepts Medicare-approved amount as payment in full. The Medicare-approved amount is the total the provider can be paid. When a provider accepts the Medicare-approved amount as payment, you won't be billed for more than the Medicare deductible & coinsureance.
Medicare Ordering & Referring
Provider can:
  • Refer to Part B
  • Order Durable Medical Equipment
  • Refer to Home Health Agency
  • Order Power Mobility Devices
Affiliations
JENNIFER DIVINE is affiliated with the following medical group(s):
  • HOSPITAL
    • POUDRE VALLEY HOSPITAL
      1024 S LEMAY AVE
      FORT COLLINS, CO 80524

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