James River Dermatology PLLC

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

0101238821 Issued in VA

Legal business name

JAMES RIVER DERMATOLOGY PLLC

Practice address

6372 Mechanicsville Tpke Ste 103
Mechanicsville, VA 23111

Phone

(804) 379-0116

Fax

(804) 379-1088

NPI assigned

Nov 14, 2016

Last updated

Sep 7, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

JAMES RIVER DERMATOLOGY PLLCAs reported in NPPES

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

Authorized official

Name

Dr. Laura Regan, MDNPI 1053474759

Title

Physician

Phone

(804) 379-0116

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• James River Dermatology PLLC

  • Dermatology Physician
  • Midlothian, VA
  • NPI 1508007840

  O20090529000396

  Same enrollment

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

CLIA laboratory certificates

Part of

James River Dermatology PLLC

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AGCHAA

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• James River Dermatology PLLC

  • Dermatology Physician
  • Midlothian, VA
  • NPI 1508007840
  NPPES parent name

Practitioners 6

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.

• Laura Elizabeth Regan, M.D.

  • Dermatology Physician
  • Midlothian, VA
  • NPI 1053474759
  NPD Authorized official
• Anna Colby, FNP-BC

  • Family Nurse Practitioner
  • Midlothian, VA
  • NPI 1093340465
  NPD
• Leslie Mays Farr, FNP-BC

  • Family Nurse Practitioner
  • Mechanicsville, VA
  • NPI 1770829079
  NPD
• Michael Craig White, M.D.

  • Dermatology Physician
  • Mechanicsville, VA
  • NPI 1255319349
  NPD
• Frederick Kim Park, M.D.

  • Plastic Surgery Physician
  • Rocky Mount, NC
  • NPI 1407964547
  NPD
• Julie Elizabeth Diegelmann, PA-C

  • Physician Assistant
  • Middleburg Heights, OH
  • NPI 1962872119
  NPD (past)

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

{
    "created_epoch": "1479081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536278400000",
    "number": "1023550654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 72605",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232358017",
            "telephone_number": "804-379-0116",
            "fax_number": "804-379-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6372 MECHANICSVILLE TPKE STE 103",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "23111",
            "telephone_number": "804-379-0116",
            "fax_number": "804-379-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES RIVER DERMATOLOGY PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JAMES RIVER DERMATOLOGY PLLC",
        "enumeration_date": "2016-11-14",
        "last_updated": "2018-09-07",
        "status": "A",
        "authorized_official_last_name": "REGAN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "804-379-0116",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "VA",
            "license": "0101238821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Verneeky Carenda Jackson, PERSONAL CARE AIDE
• Patricia Jacob, P.T.
• Saeed Jadali, M.D.
• Annabelle Claire Jajuga
• James H Cane MD PC
• James River Emergency Group, LLC
• Brianna James
• Christopher Gregory James, LCSW
• Harlee James, LPC, NCC
• Allyn Gardner Janney Jr., DDS

• Procedural Dermatology Physician in Mechanicsville, VA
• Providers in Mechanicsville, VA by specialty
• Procedural Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; 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.