NPIMap

Organization Active NPI

Central Montgomery Dermatology

  • Dermatology Physician
  • Lansdale, PA
National Provider Identifier
1083685739
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
CENTRAL MONTGOMERY DERMATOLOGY
Practice address
1003 S Broad St
Lansdale, PA 19446-5338
Phone
(215) 361-5030
Fax
(215) 412-3587
NPI assigned
Jan 31, 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
James Fairfield, MDNPI 1861495061
Title
Owner
Phone
(215) 361-5030

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 Physician 207N00000X NU Primary

Addresses

Primary practice location

1003 S Broad St
Lansdale, PA 19446-5338

Mailing address

1003 S Broad St
Lansdale, PA 19446-5338
Phone (215) 361-5030

National Provider Directory

National Provider Directory

Locations

1003 S Broad St
Lansdale, PA 19446
Phone (215) 361-5030

Practitioners & affiliated clinicians

Practitioners 3

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": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083685739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 S BROAD ST",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194465338",
            "telephone_number": "215-361-5030",
            "fax_number": "215-412-3587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 S BROAD ST",
            "city": "LANSDALE",
            "state": "PA",
            "postal_code": "194465338",
            "telephone_number": "215-361-5030",
            "fax_number": "215-412-3587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MONTGOMERY DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FAIRFIELD",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-361-5030",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansdale, PA

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.