Mid Atlantic Dermatology

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

MID ATLANTIC DERMATOLOGY

Practice address

109 Wimbledon SQ
Suite E
Chesapeake, VA 23320-4945

Phone

(757) 547-9830

Fax

(757) 548-0721

NPI assigned

Sep 28, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Rose Ann Waller

Title

Billing Manager

Phone

(757) 547-9830

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 5

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

• Michael Leslie Gross, M.D.

  • Dermatology Physician
  • Virginia Beach, VA
  • NPI 1932105285
  Medicare reassignment NPD
• Janel Fellner, PA

  • Medical Physician Assistant
  • Chesapeake, VA
  • NPI 1548255185
  Medicare reassignment
• Holly Ann Buchanan, NP

  • Nurse Practitioner
  • Chesapeake, VA
  • NPI 1235188111
  NPD (past)
• Lorie Ann Conza, NP-C

  • Family Nurse Practitioner
  • Norfolk, VA
  • NPI 1780982348
  NPD (past)
• Deborah Paige Quinn, NP

  • Nurse Practitioner
  • Norfolk, VA
  • NPI 1700028628
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1073605333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 WIMBLEDON SQ",
            "address_2": "SUITE E",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204945",
            "telephone_number": "757-547-9830",
            "fax_number": "757-548-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 WIMBLEDON SQ",
            "address_2": "SUITE E",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204945",
            "telephone_number": "757-547-9830",
            "fax_number": "757-548-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID ATLANTIC DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "757-547-9830",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael S. Weissman, PH.D.,LTD (Churchland Psychological Center)
• Claire Vanness Michaux, COTA/L
• Lakisha K Michel, COSMETOLOGIST
• Rachel Lynne Micheletti, LPC
• Lisa Mickley, MD
• Mid-Atlantic Homecare
• Mid-Atlantic Womens Care PLC
• Mid-Atlantic Womens Care PLC (Virginia Center for Women)
• Mid-Atlantic Womens Care PLC
• Mid-Atlantic Womens Care PLC (TotalCare for Women)

• Dermatology Physician in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; 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.