Derm on Demand LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R1232822 Issued in MN

Legal business name

DERM ON DEMAND LLC

Practice address

7940 Main St N
Maple Grove, MN 55369-7169

Phone

(763) 350-6810

NPI assigned

Apr 23, 2013

Last updated

Jun 3, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Risa Ann Asmus Dorweiler, ANP

Title

Owner/Provider

Phone

(763) 350-6810

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370217600000",
    "number": "1225472046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7940 MAIN ST N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697169",
            "telephone_number": "763-350-6810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7940 MAIN ST N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697169",
            "telephone_number": "763-350-6810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERM ON DEMAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-23",
        "last_updated": "2013-06-03",
        "status": "A",
        "authorized_official_last_name": "DORWEILER",
        "authorized_official_first_name": "RISA",
        "authorized_official_middle_name": "ANN ASMUS",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "763-350-6810",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ANP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R1232822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187282600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Maccarthy Demanivel, MD
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• Dentalign P.a.
• Phillip John Detlefsen, D.C.
• Parker Deutz, DPT
• Karmen Rae Dezeeuw, ATC
• Sonia Anil Dhumne, DDS
• Safiatou Diallo

• Nurse Practitioner in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; 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.