Active NPI
Forefront Dermatology, S.C.
- Dermatology Physician
- Scottsburg, IN
National Provider Identifier
1003211392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Legal business name
- FOREFRONT DERMATOLOGY, S.C.
- Practice address
- 1473 N Gardner St Ste a
C/O Scott Memorial Hospital
Scottsburg, IN 47170 - Phone
- (812) 752-3512
- Fax
- (812) 752-8593
- NPI assigned
- Oct 29, 2014
- Last updated
- May 28, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Betsy J Wernli, MD
- Title
- President
- Phone
- (920) 482-0671
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | NU | Primary |
Addresses
Primary practice location
1473 N Gardner St Ste a
C/O Scott Memorial Hospital
Scottsburg, IN 47170
Mailing address
801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9016
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140425001640 | IN | Part B Supplier - Clinic/Group Practice | 3779471701 |
Receives reassigned benefits from 44 practitioners 24 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Kokomo, IN; Marion, IN; Mooresville, IN; Noblesville, IN; Salem, IN; Crown Point, IN; Scottsburg, IN; Seymour, IN… |
Other NPIs on the same Medicare enrollment 24
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1414540800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1590624000000",
"number": "1003211392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 YORK ST",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542204630",
"telephone_number": "920-663-9016",
"fax_number": "920-684-1439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1473 N GARDNER ST STE A",
"address_2": "C/O SCOTT MEMORIAL HOSPITAL",
"city": "SCOTTSBURG",
"state": "IN",
"postal_code": "47170",
"telephone_number": "812-752-3512",
"fax_number": "812-752-8593"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FOREFRONT DERMATOLOGY, S.C.",
"organizational_subpart": "NO",
"enumeration_date": "2014-10-29",
"last_updated": "2020-05-28",
"certification_date": "2020-05-28",
"status": "A",
"authorized_official_last_name": "WERNLI",
"authorized_official_first_name": "BETSY",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "920-482-0671",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsburg, IN
- Family Medical Associates P C
- Sara L Feltner, FNPC
- First Urology, PSC
- Beth Joellen Fleenor, OTR
- Jonathan Dale Ford I, MA
- Forefront Dermatology, S.C.
- Fresenius Medical Care Nak Scott County, LLC (Fresenius Medical Care Scott County)
- Gardenside Dialysis LLC (Scottsburg Dialysis)
- Gardner Street Emergency Physicians
- Sara Garrison, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.