Greenwood Dermatology PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

01047160 Issued in IN

Legal business name

GREENWOOD DERMATOLOGY PC

Practice address

53 South Park Blvd
Greenwood, IN 46143

Phone

(317) 889-7546

Fax

(317) 889-2482

NPI assigned

Apr 17, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Thomas J Eads, M.D.NPI 1942303151

Title

President

Phone

(317) 889-7546

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 3

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.

• Thomas J Eads, MD

  • Dermatology Physician
  • Greenwood, IN
  • NPI 1942303151
  Medicare reassignment NPD Authorized official
• Larry J Buckel, MD

  • Dermatopathology Physician
  • Greenwood, IN
  • NPI 1811090939
  NPD
• Laura T Stitle, MD

  • Dermatology Physician
  • Greenwood, IN
  • NPI 1457446247
  NPD

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208390400000",
    "number": "1285808550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 SOUTH PARK BLVD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "46143",
            "telephone_number": "317-889-7546",
            "fax_number": "317-889-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 SOUTH PARK BLVD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "46143",
            "telephone_number": "317-889-7546",
            "fax_number": "317-889-2482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENWOOD DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-17",
        "last_updated": "2008-04-17",
        "status": "A",
        "authorized_official_last_name": "EADS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-889-7546",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01047160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greenwood 65 Low Cost RX (Low Cost Pharmacy)
• Greenwood 65 Low Cost RX Inc
• Greenwood Chiropractic, Inc. (Performance Chiropractic and Sports Rehab.)
• Greenwood Community School Corporation
• Greenwood Dental Care
• Greenwood Family Care a.S.a.P. LLC
• Greenwood Family Chiropractic, LLC
• Greenwood Fire Department
• Greenwood Group Health, LLC
• Greenwood Health & Living Center

• Dermatology Physician in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Dermatology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; 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.