Highlands Dermatology and Surgical Associates

Primary specialty

SpecialistTaxonomy code 174400000X

License

18375 Issued in TN

Legal business name

HIGHLANDS DERMATOLOGY AND SURGICAL ASSOCIATES

Practice address

112 N Walnut Ave
Cookeville, TN 38501-2554

Phone

(931) 520-1414

Fax

(931) 520-1246

NPI assigned

May 17, 2013

Organization subpart

No

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

Authorized official

Name

Richard S Hall, M.D.NPI 1952368870

Title

Owner

Phone

(931) 520-1414

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

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 7

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

• Richard Scott Hall, M.D.

  • MOHS-Micrographic Surgery Physician
  • Cookeville, TN
  • NPI 1952368870
  Medicare reassignment Care Compare group NPD Authorized official
• Christie Hummel, FNP-BC

  • Family Nurse Practitioner
  • Cookeville, TN
  • NPI 1962740217
  Medicare reassignment Care Compare group NPD
• Tina Kelly, MSN, FNP-C

  • Family Nurse Practitioner
  • Union City, TN
  • NPI 1871277285
  Medicare reassignment Care Compare group NPD
• Amber Beth Hoffert, P.A.

  • Physician Assistant
  • Cookeville, TN
  • NPI 1407044514
  Medicare reassignment Care Compare group
• Rochelle M Lamb, APN

  • Nurse Practitioner
  • Sarasota, FL
  • NPI 1427023837

  TN

  Medicare reassignment NPD
• Richard Harold Gentry, M.D.

  • Dermatology Physician
  • Cookeville, TN
  • NPI 1245297019
  NPD
• Elizabeth Gail Cicutto, P.A.

  • Medical Physician Assistant
  • Cookeville, TN
  • NPI 1356307417
  NPD (past)

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

{
    "created_epoch": "1368748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368748800000",
    "number": "1093151045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1210",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385031210",
            "telephone_number": "931-520-1414",
            "fax_number": "931-520-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 N WALNUT AVE",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012554",
            "telephone_number": "931-520-1414",
            "fax_number": "931-520-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLANDS DERMATOLOGY AND SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-17",
        "last_updated": "2013-05-17",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-520-1414",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TN",
            "license": "18375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaelyn Hiers
• Benjamin Higgins, MA, LPC-MHSP
• Highland Medical Carriers LLC
• Highland Rim Respiratory Specialists
• Highlands Dental PLLC (Highlands Dental)
• Highlands Healthcare, PLLC
• Highlands OB-GYN, PLLC
• Caleb T Hill, BEHAVIOR TECHNICIAN
• Delilah Jane Hill, BS
• Janice Hill

• Specialist in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2013; 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.