Organization Active NPI

Nashville Dermatology & Skin Cancer Clinic

  • Specialist
  • Nashville, TN
National Provider Identifier
1235320326
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD28596 Issued in TN
Legal business name
NASHVILLE DERMATOLOGY & SKIN CANCER CLINIC
Practice address
222 State St.
Suite a
Nashville, TN 37203-1869
Phone
(615) 327-2075
Fax
(615) 329-4058
NPI assigned
Aug 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Authorized official

Name
Barbara Tillman Keyes, M.D.NPI 1427044148
Title
Doctor
Phone
(615) 327-2075

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MD28596 TN Primary

Addresses

Primary practice location

222 State St.
Suite a
Nashville, TN 37203-1869

Mailing address

222 State St.
Suite a
Nashville, TN 37203-1869
Phone (615) 327-2075

Other identifiers 2

IdentifierTypeStateIssuer
3044049OtherTNBCBS
5066203OtherTNAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040920000542 TN Part B Supplier - Clinic/Group Practice 6103894068 Receives reassigned benefits from 1 practitioner
Practice locations: Nashville, TN

National Provider Directory

National Provider Directory

Locations

2222 State St
Ste A
Nashville, TN 37203
Phone (615) 327-2075

Practitioners & affiliated clinicians

Practitioners 2

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": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1235320326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 STATE ST.",
            "address_2": "SUITE A",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031869",
            "telephone_number": "615-327-2075",
            "fax_number": "615-329-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 STATE ST.",
            "address_2": "SUITE A",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031869",
            "telephone_number": "615-327-2075",
            "fax_number": "615-329-4058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NASHVILLE DERMATOLOGY & SKIN CANCER CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "KEYES",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "TILLMAN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "615-327-2075",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD28596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3044049",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5066203",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.