Dermatology Center for Skin Health

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

21247 Issued in WV

Legal business name

DERMATOLOGY CENTER FOR SKIN HEALTH

Practice address

600 Suncrest Town Centre Dr Ste 115
Morgantown, WV 26505-1873

Phone

(304) 598-3888

Fax

(304) 598-0564

NPI assigned

May 14, 2007

Organization subpart

No

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

Authorized official

Name

Barbara Hawthorne

Title

Practice Administrator

Phone

(304) 225-2236

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: mmaouad@dermcentersh.emadirect.md

Practitioners 3

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

• Rola Michelle Gharib, M.D.

  • Dermatology Physician
  • Morgantown, WV
  • NPI 1760686927
  Medicare reassignment Care Compare group NPD
• Michele M Maouad, MD

  • Dermatology Physician
  • Morgantown, WV
  • NPI 1013991355
  Medicare reassignment Care Compare group NPD
• Sarah Proffitt, FNP-BC

  • Family Nurse Practitioner
  • Morgantown, WV
  • NPI 1174693386
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572998400000",
    "number": "1114132867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SUNCREST TOWN CENTRE DR STE 115",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265051873",
            "telephone_number": "304-598-3888",
            "fax_number": "304-598-0564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SUNCREST TOWN CENTRE DR STE 115",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265051873",
            "telephone_number": "304-598-3888",
            "fax_number": "304-598-0564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY CENTER FOR SKIN HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2019-11-06",
        "status": "A",
        "authorized_official_last_name": "HAWTHORNE",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "304-225-2236"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "WV",
            "license": "21247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "001722467",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810002533",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLAN",
            "identifier": "WV21247A",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmaouad@dermcentersh.emadirect.md",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "600 Suncrest Town Centre Dr Ste 115",
            "city": "Morgantown",
            "state": "WV",
            "country_code": "US",
            "postal_code": "265051873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alana Dennison, LMT
• Woody L Dennison, CRNA
• Dependency Counseling PLLC
• Mary Grace Deprimio, PA-C
• Stephanie E Derby
• Dermatology Center for Skin Health, PLLC
• Megan M Deruiter, CFNP
• Bharati Desai, M.D.
• Marilyn Louise Desantis, FNP
• Ashwin Pramod Deshmukh, MBBS

• Dermatology Physician in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Dermatology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; 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.