NPIMap

Organization Active NPI

Atlantic Dermatology Associates PC

  • Specialist
  • Virginia Beach, VA
National Provider Identifier
1033159454
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ATLANTIC DERMATOLOGY ASSOCIATES PC
Practice address
1101 First Colonial Rd
Suite 200
Virginia Beach, VA 23454-2409
Phone
(757) 481-1666
Fax
(757) 481-7696
NPI assigned
Jun 7, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Tami Lorraine Colon
Title
Office Manager
Phone
(757) 481-1666

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1101 First Colonial Rd
Suite 200
Virginia Beach, VA 23454-2409

Mailing address

1101 First Colonial Rd
Suite 200
Virginia Beach, VA 23454-2409
Phone (757) 481-1666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050301000793 VA Part B Supplier - Clinic/Group Practice 2961455076 Receives reassigned benefits from 9 practitioners
Practice locations: Cape Charles, VA; Virginia Beach, VA

National Provider Directory

National Provider Directory

Locations

1101 First Colonial Rd
Ste 200
Virginia Beach, VA 23454
Phone (757) 481-1666

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033159454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 FIRST COLONIAL RD",
            "address_2": "SUITE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542409",
            "telephone_number": "757-481-1666",
            "fax_number": "757-481-7696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 FIRST COLONIAL RD",
            "address_2": "SUITE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542409",
            "telephone_number": "757-481-1666",
            "fax_number": "757-481-7696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC DERMATOLOGY ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COLON",
        "authorized_official_first_name": "TAMI",
        "authorized_official_middle_name": "LORRAINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "757-481-1666",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.