Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Mountain West Derm - Blackhart Pllc

Dermatology Physician in Roseburg, OR · enumerated 2021 · authorized official Jeffrey Shackelton, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1891467577

Verified

See something wrong? Report a correction

Registry record

Entity type Organization (Type 2)

Legal business name Mountain West Derm - Blackhart Pllc

Practice address 341 Nw Medical Loop Ste 110, Roseburg, OR, 97471

Phone (541) 440-2165

Fax (541) 440-8932

Enumeration date Oct 1, 2021

Last updated in NPPES Oct 4, 2021

Taxonomy & classification

207N00000X Dermatology Physician Allopathic & Osteopathic Physicians Primary

Authorized official

Name Jeffrey Shackelton

Title Owner

Phone (775) 283-4086

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What type of organization is Mountain West Derm - Blackhart Pllc?

Mountain West Derm - Blackhart Pllc is registered in NPPES as a Dermatology Physician (its primary provider taxonomy).

What is a Type 2 NPI?

A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2021-10-04.