NPIMap

Organization Active NPI

Forefront Dermatology, S.C.

Doing business as Advanced Dermatology & Skin Care Centre

  • Dermatology Physician
  • Miramar Beach, FL
National Provider Identifier
1154815546
Registry record updated Dec 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
FOREFRONT DERMATOLOGY, S.C.
Doing business as
Advanced Dermatology & Skin Care Centre
Practice address
7720 US Highway 98 W Ste 240
Miramar Beach, FL 32550-7232
Phone
(850) 502-5989
Fax
(850) 266-6301
NPI assigned
Jun 19, 2018
Last updated
Dec 24, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2024

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

Authorized official

Name
Dr. Betsy J Wernli, MDNPI 1437378973
Title
President
Phone
(920) 482-0671

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0101X
Procedural Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207NS0135X

Addresses

Primary practice location

7720 US Highway 98 W Ste 240
Miramar Beach, FL 32550-7232

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other practice location 1

4400 E Highway 20 Ste 209
Niceville, FL 32578
Phone (850) 502-5989

Other practice location 2

4592 E Highway 20 Ste 3
Niceville, FL 32578-7711
Phone (850) 389-4955

Other names 1

  • Advanced Dermatology & Skin Care Centre Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181019000122 FL Part B Supplier - Clinic/Group Practice 3779471701 Receives reassigned benefits from 49 practitioners
11 other NPIs on this enrollment
Practice locations: Miramar Beach, FL; Niceville, FL; Orlando, FL; Panama City Beach, FL; Pensacola, FL; Winter Park, FL; Melbourne, FL; Fort Lauderdale, FL…

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 51

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.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734998400000",
    "number": "1154815546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7720 US HIGHWAY 98 W STE 240",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325507232",
            "telephone_number": "850-502-5989",
            "fax_number": "850-266-6301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4400 E Highway 20 Ste 209",
            "address_purpose": "LOCATION",
            "city": "Niceville",
            "state": "FL",
            "postal_code": "32578",
            "country_code": "US",
            "telephone_number": "850-502-5989",
            "fax_number": "850-266-6301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4592 E Highway 20 Ste 3",
            "address_purpose": "LOCATION",
            "city": "Niceville",
            "state": "FL",
            "postal_code": "325787711",
            "country_code": "US",
            "telephone_number": "850-389-4955",
            "fax_number": "850-266-6301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FOREFRONT DERMATOLOGY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-19",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-24",
        "status": "A",
        "authorized_official_last_name": "WERNLI",
        "authorized_official_first_name": "BETSY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-482-0671",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dermatology & Skin Care Centre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miramar Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2024; 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.