Jennifer Divine, MD
Jennifer Divine, MD is a MOHS-Micrographic Surgery Physician in Fort Collins, CO, registered under NPI 1063779072. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 1260 DOCTOR'S LANE, Fort Collins, CO 80524. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| DR.0058205 | CO | MOHS-Micrographic Surgery Physician primary |
| ME 131766 | FL | MOHS-Micrographic Surgery Physician |
Licences are recorded in 2 states: CO, FL. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - Dermatology
- PAC ID
- 7911278213
- Enrollment ID
- I20170804002141
Medicare enrolment is recorded as approved under the provider type Practitioner - Dermatology. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 2 states
This provider holds licences in 2 states: Colorado and Florida. The practice address on file is in Fort Collins, CO, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
- Licence
- DR.0058205
- Specialty
- MOHS-Micrographic Surgery Physician
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What MOHS-Micrographic Surgery covers
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. NUCC Health Care Provider Taxonomy, code 207ND0101X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 207ND0101X | MOHS-Micrographic Surgery Physician MOHS-Micrographic Surgery | DR.0058205 | CO | primary |
| 207ND0101X | MOHS-Micrographic Surgery Physician MOHS-Micrographic Surgery | ME 131766 | FL |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1063779072 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Apr 15, 2012 |
| Last updated | Jul 19, 2024 |
| Status | Active |
| Sole proprietor | Yes |
| Credential | MD |
| Practice address |
1260 DOCTOR'S LANE Fort Collins, CO 80524 (970) 286-2668 Fax (970) 294-4954 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 0 | 6 | 3 | 7 | 7 | 9 | 0 | 7 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 0 | 3 | 3 | 5 | 7 | 9 | 0 | 5 |
Sum = 58 · next multiple of 10 = 60 · check digit = 2 · actual last digit = 2
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.