Individual provider Active NPI

Joanna Gammons, D.O.

  • Dermatology Physician
  • Royal Oak, MI
National Provider Identifier
1255371670
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
JG014835 Issued in MI
Practice address
713 N Main St
Royal Oak, MI 48067-1835
Phone
(248) 548-7707
Fax
(248) 548-7736
NPI assigned
Jun 7, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X JG014835 MI Primary

Addresses

Primary practice location

713 N Main St
Royal Oak, MI 48067-1835

Mailing address

713 N Main St
Royal Oak, MI 48067-1835
Phone (248) 548-7707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050602000554 MI Practitioner - Dermatology 0244273126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 W 11 Mile Rd
Royal Oak, MI 48067-2454
Phone (248) 439-6375

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal13
Melanoma (skin cancer) excision1-10
Removal of skin lesions1690
Removal or shaving of skin growth1-10
Skin biopsy16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
JG014835MIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Healthcare Professionals PC Dermatology CurrentSince Aug 9, 2016 Accepting new patients
Michigan Healthcare Professionals PC CurrentSince Aug 9, 2016 Accepting new patients
Koprince Dermatology PLC Dermatology Past Accepting new patients

Locations

27900 Grand River Ave
Ste 220
Farmington Hills, MI 48336
Phone (248) 477-0552

29992 Northwestern Hwy
Ste C
Farmington Hills, MI 48334
Phone (248) 851-1430

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

1200 W 11 Mile Rd
Royal Oak, MI 48067
Phone (248) 268-3770

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1255371670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 N MAIN ST",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480671835",
            "telephone_number": "248-548-7707",
            "fax_number": "248-548-7736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 N MAIN ST",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480671835",
            "telephone_number": "248-548-7707",
            "fax_number": "248-548-7736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMMONS",
        "first_name": "JOANNA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "JG014835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.