Dermatology Office PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY OFFICE PC

Practice address

1600 W Harper St
Poplar Bluff, MO 63901-4119

Phone

(573) 686-4750

Fax

(573) 686-4753

NPI assigned

Oct 15, 2008

Organization subpart

No

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

Authorized official

Name

Vanessa AdamsNPI 1316486202

Title

Owner/Provider

Phone

(573) 686-4750

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, AR2 enrollments

Enrollment records 2

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 12

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

• Vanessa Adams, NP-C

  • Family Nurse Practitioner
  • Poplar Bluff, MO
  • NPI 1316486202
  Medicare reassignment Care Compare group NPD Authorized official
• Michelle E Burnham, FNP

  • Family Nurse Practitioner
  • Van Buren, MO
  • NPI 1275781254
  Medicare reassignment Care Compare group NPD
• Zachary Paul Nahmias, M.D.

  • Dermatology Physician
  • Jonesboro, AR
  • NPI 1093129397

  MO

  Medicare reassignment Care Compare group NPD
• Haley Burnett, DNP

  • Family Nurse Practitioner
  • Poplar Bluff, MO
  • NPI 1811668460
  Medicare reassignment Care Compare group
• Farrah Traquel McSpadden, M.D.

  • Obstetrics & Gynecology Physician
  • Sikeston, MO
  • NPI 1205053758
  Medicare reassignment NPD
• Brandice A Rogers, APN

  • Family Nurse Practitioner
  • Marmaduke, AR
  • NPI 1437465929
  Medicare reassignment NPD
• Courtney Jean Stewart, APRN, NP-C

  • Family Nurse Practitioner
  • Paragould, AR
  • NPI 1629557582
  Medicare reassignment NPD
• Zachary L Ferguson, PA

  • Physician Assistant
  • Poplar Bluff, MO
  • NPI 1376008334
  Medicare reassignment
• Richard Scott Crouse, FNP

  • Nurse Practitioner
  • Poplar Bluff, MO
  • NPI 1548489453
  NPD (past)
• Anderson Mark Gilberto, DDS

  • General Practice Dentistry
  • Poplar Bluff, MO
  • NPI 1790270494
  NPD (past)
• Randal L. Hillis, DDS

  • Dentist
  • Poplar Bluff, MO
  • NPI 1710933353
  NPD (past)
• Oma L Shelton, CFNP

  • Family Nurse Practitioner
  • Bolivar, MO
  • NPI 1083679104
  NPD (past)

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1043462591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W HARPER ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014119",
            "telephone_number": "573-686-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W HARPER ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639014119",
            "telephone_number": "573-686-4750",
            "fax_number": "573-686-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY OFFICE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-15",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "573-686-4750"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Dellinger
• Dillon Demaree
• Jennifer Dennis, PHARM D
• Dental Arts Group L.L.C
• Department of Veterans Affairs
• Mary L Deschler, LCSW
• Robert L Dever, M.D.
• Sonya D Diciro, F.N.P.
• Tiffany Heather Dickmann
• Anthony Disalvo III, DMD

• Dermatology Physician in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Dermatology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.