Commonwealth Dermatology, PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

0101026447 Issued in VA

Legal business name

COMMONWEALTH DERMATOLOGY, PC

Practice address

7001 Forest Ave
Ste. 400
Richmond, VA 23230-1726

Phone

(804) 282-0831

Fax

(804) 288-7135

NPI assigned

Oct 25, 2006

Last updated

Sep 3, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hazle Konerding, MD

Title

President

Phone

(804) 282-0831

Specialties & licenses 7

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VA

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 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Darren Guffey, M.D.

  • Dermatology Physician
  • Charlottesville, VA
  • NPI 1003202433
  Medicare reassignment Care Compare group NPD
• Camille A Haisley-Royster, MD

  • Dermatology Physician
  • Richmond, VA
  • NPI 1366404816
  Medicare reassignment Care Compare group NPD
• Rachel Balow Lee, MD

  • Dermatology Physician
  • Richmond, VA
  • NPI 1659934073
  Medicare reassignment Care Compare group NPD
• Samantha Martin, FNP-C

  • Family Nurse Practitioner
  • Richmond, VA
  • NPI 1316468465
  Medicare reassignment Care Compare group NPD
• Neel Som Nath, MD

  • Dermatology Physician
  • Richmond, VA
  • NPI 1386149102
  Medicare reassignment Care Compare group NPD
• Jessica Evelyn Payne, MD

  • Dermatology Physician
  • Richmond, VA
  • NPI 1881213445
  Medicare reassignment Care Compare group NPD
• Matthew Jason Sage, M.D.

  • Dermatology Physician
  • Richmond, VA
  • NPI 1861754426
  Medicare reassignment Care Compare group NPD
• Hazel J Vernon, MD

  • Dermatology Physician
  • Richmond, VA
  • NPI 1316907371
  Medicare reassignment Care Compare group NPD
• Ana Snow Wiley, AGPCNP

  • Adult Health Nurse Practitioner
  • Richmond, VA
  • NPI 1750803961
  Medicare reassignment Care Compare group NPD
• Sarah A.L. Skillman, M.D.

  • Dermatology Physician
  • Atlanta, GA
  • NPI 1801157615

  VA

  Medicare reassignment Care Compare group NPD
• Mary Kathleen Vaughan Graves, PA-C

  • Physician Assistant
  • Richmond, VA
  • NPI 1336562743
  Medicare reassignment Care Compare group
• Laurie L Shinn, MD

  • Dermatology Physician
  • Richmond, VA
  • NPI 1700848256
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409702400000",
    "number": "1013091115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7001 FOREST AVE",
            "address_2": "STE. 400",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232301726",
            "telephone_number": "804-282-0831",
            "fax_number": "804-288-7135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 FOREST AVE",
            "address_2": "STE. 400",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232301726",
            "telephone_number": "804-282-0831",
            "fax_number": "804-288-7135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH DERMATOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2014-09-03",
        "status": "A",
        "authorized_official_last_name": "KONERDING",
        "authorized_official_first_name": "HAZLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-282-0831",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0017137835",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0017138217",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101233942",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101026447",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "VA",
            "license": "0101238054",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "VA",
            "license": "0101053332",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "VA",
            "license": "0101044250",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB6342",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM GROUP NO.",
            "identifier": "057917",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA GROUP NO.",
            "identifier": "3118456",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Commonwealth Catholic Charities
• Commonwealth Catholic Charities
• Commonwealth Chiropractic and Acupuncture Center P C
• Commonwealth Clinical & Consulting Services
• Commonwealth Dental Anesthesia Associates PC
• Commonwealth Endodontics
• Commonwealth General & Vascular Surgery, P.C.
• Commonwealth Health Group LLC
• Commonwealth Hearing AIDS Inc
• Commonwealth Heart Center, Inc.

• Dermatology Physician in Richmond, VA
• Providers in Richmond, VA by specialty
• Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; 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.