Premier Dermatology

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

35.070376 Issued in OH

Legal business name

PREMIER DERMATOLOGY

Practice address

29001 Cedar Rd
Suite 203
Lyndhurst, OH 44124-4062

Phone

(440) 684-9933

NPI assigned

Dec 31, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Janet Wieselthier, MDNPI 1639174386

Title

Owner

Phone

(440) 684-9953

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Janet S Wieselthier, M.D.

  • Dermatopathology Physician
  • Lyndhurst, OH
  • NPI 1639174386
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1262217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262217600000",
    "number": "1003146721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29001 CEDAR RD",
            "address_2": "SUITE 203",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441244062",
            "telephone_number": "440-684-9933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29001 CEDAR RD",
            "address_2": "SUITE 203",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441244062",
            "telephone_number": "440-684-9933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-31",
        "last_updated": "2009-12-31",
        "status": "A",
        "authorized_official_last_name": "WIESELTHIER",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-684-9953",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "OH",
            "license": "35.070376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatopathology Physician in Lyndhurst, OH
• Providers in Lyndhurst, OH by specialty
• Dermatopathology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.