Organization Active NPI

RW Dermatology

  • Dermatology Physician
  • Furlong, PA
National Provider Identifier
1043854292
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
RW DERMATOLOGY
Practice address
2325 Heritage Center Dr Ste 119
Furlong, PA 18925-1262
Phone
(267) 824-4400
Fax
(267) 824-4600
NPI assigned
Oct 31, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Authorized official

Name
Rachel Marie WhiteNPI 1447633490
Title
Dermatologist
Phone
(267) 824-4400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

2325 Heritage Center Dr Ste 119
Furlong, PA 18925-1262

Mailing address

2325 Heritage Center Dr Ste 119
Furlong, PA 18925-1262

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200110000313 PA Part B Supplier - Clinic/Group Practice 6608201116 Receives reassigned benefits from 3 practitioners
Practice locations: Furlong, PA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D2219292RW Dermatology2325 Heritage Center Drive, Suite 119, Furlong, PA 18925ComplianceOct 6, 2027

National Provider Directory

National Provider Directory

Locations

2325 Heritage Center Dr
Ste 119
Furlong, PA 18925
Phone (267) 824-4400

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1572480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577664000000",
    "number": "1043854292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 HERITAGE CENTER DR STE 119",
            "city": "FURLONG",
            "state": "PA",
            "postal_code": "189251262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 HERITAGE CENTER DR STE 119",
            "city": "FURLONG",
            "state": "PA",
            "postal_code": "189251262",
            "telephone_number": "267-824-4400",
            "fax_number": "267-824-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RW DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-31",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DERMATOLOGIST",
        "authorized_official_telephone_number": "267-824-4400"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Furlong, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2019; 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.