NPIMap

Organization Active NPI

Medical Arts Dermatology, PA

  • Dermatology Physician
  • Corsicana, TX
National Provider Identifier
1063849990
Registry record updated Oct 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
J6338 Issued in TX
Legal business name
MEDICAL ARTS DERMATOLOGY, PA
Practice address
401 Hospital Dr Ste 100
Corsicana, TX 75110-2415
Phone
(903) 875-0413
Fax
(903) 872-4467
NPI assigned
Oct 10, 2013
Last updated
Oct 10, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2013

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

Authorized official

Name
Dr. John M Bitlz, M.D.
Title
Owner
Phone
(903) 875-0413

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X J6338 TX Primary

Addresses

Primary practice location

401 Hospital Dr Ste 100
Corsicana, TX 75110-2415

Mailing address

401 Hospital Dr Ste 100
Corsicana, TX 75110-2415
Phone (903) 875-0413

Other identifiers 1

IdentifierTypeStateIssuer
1225001860OtherTXNPI

National Provider Directory

National Provider Directory

Locations

401 Hospital Dr
#100
Corsicana, TX 75110
Phone (903) 875-0413

401 Hospital Dr
Ste 100
Corsicana, TX 75110
Phone (903) 875-0413

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7873/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

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": "1381363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381363200000",
    "number": "1063849990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HOSPITAL DR STE 100",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751102415",
            "telephone_number": "903-875-0413",
            "fax_number": "903-872-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HOSPITAL DR STE 100",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751102415",
            "telephone_number": "903-875-0413",
            "fax_number": "903-872-4467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ARTS DERMATOLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-10",
        "last_updated": "2013-10-10",
        "status": "A",
        "authorized_official_last_name": "BITLZ",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-875-0413",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "J6338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1225001860",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corsicana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.