NPIMap

Organization Active NPI

Anders Dermatology Incorporated

  • Dermatology Physician
  • Toledo, OH
National Provider Identifier
1215968896
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ANDERS DERMATOLOGY INCORPORATED
Practice address
4126 N Holland Sylvania Rd
Suite 200
Toledo, OH 43623-3536
Phone
(419) 473-3257
Fax
(419) 473-8816
NPI assigned
Jul 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Authorized official

Name
Dr. John P Anders, M.D.NPI 1811932643
Title
President
Phone
(419) 473-3257

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

4126 N Holland Sylvania Rd
Suite 200
Toledo, OH 43623-3536

Mailing address

4126 N Holland Sylvania Rd
Suite 200
Toledo, OH 43623-2504
Phone (419) 473-3257

Other identifiers 1

IdentifierTypeStateIssuer
P00102183OtherOHMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040603000116 OH Part B Supplier - Clinic/Group Practice 2163404294 Receives reassigned benefits from 11 practitioners
Practice locations: Toledo, OH

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D1056831Anders Dermatology, Inc4126 N Holland-Sylvania Road, Suite 200, Toledo, OH 43623ComplianceJan 23, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194912000000",
    "number": "1215968896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4126 N HOLLAND SYLVANIA RD",
            "address_2": "SUITE 200",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436232504",
            "telephone_number": "419-473-3257",
            "fax_number": "419-473-8816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4126 N HOLLAND SYLVANIA RD",
            "address_2": "SUITE 200",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233536",
            "telephone_number": "419-473-3257",
            "fax_number": "419-473-8816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERS DERMATOLOGY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2007-11-13",
        "status": "A",
        "authorized_official_last_name": "ANDERS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-473-3257",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00102183",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; 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.