Forefront Dermatology, S.C.
Organization Active NPI Dermatology Physician · Mooresville, IN
NPI 1295107191 · NPPES record last updated May 21, 2018
Key facts
- NPI
- 1295107191
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- Legal business name
- FOREFRONT DERMATOLOGY, S.C.
- Practice address
- 100 Town Center Rd S Ste C
Mooresville, IN 46158 - Phone
- (317) 834-5466
- Fax
- (888) 358-7705
- NPI assigned
- Oct 30, 2015
- Organization subpart
- No
Authorized official
- Name
- Dr. Betsy J Wernli, MD
- Title
- President
- Phone
- (920) 482-0671
Other NPIs on the same Medicare enrollment 24
Practitioners 3
-
Olivia Mae Eckstein, PA-C
-
Amber Lee Kelley, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140425001640 | IN | Part B Supplier - Clinic/Group Practice | 3779471701 |
Receives reassigned benefits from 44 practitioners 24 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Kokomo, IN; Marion, IN; Mooresville, IN; Noblesville, IN; Salem, IN; Crown Point, IN; Scottsburg, IN; Seymour, IN… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | Yes | ||
| Procedural Dermatology Physician |
207NS0135X |
Addresses
Primary practice location
100 Town Center Rd S Ste C
Mooresville, IN 46158
Mailing address
801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9016
Other providers in Mooresville, IN
- Erin a. Rake, DDS
- Helmut Falk Jr.
- Philip Faris
- Donald T Fischer
- Andrea Kristine Fisher
- Elizabeth Marie Fox
- Britani N Frame
- Francis J. Bean DPM PC
- Franciscan Health Indianapolis & Mooresville
- Franciscan Health Olympia Fields
All providers in Mooresville, IN · Dermatology Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.