Adult & Pediatric Dermatology Skin Solutions PLLC

Organization Active NPI Medical Physician Assistant · Tullahoma, TN

NPI 1295324366 · NPPES record last updated Jun 1, 2022

Key facts

NPI
1295324366
Entity type
Organization (NPI type 2)
Primary specialty
Medical Physician Assistant 363AM0700X
Legal business name
ADULT & PEDIATRIC DERMATOLOGY SKIN SOLUTIONS PLLC
Practice address
151 Ledford Mill Rd
Tullahoma, TN 37388-2278
Phone
(931) 800-6400
Fax
(931) 800-6401
NPI assigned
Jan 13, 2021
Organization subpart
No

Authorized official

Name
Lorie M Burtts
Title
Office Manager
Phone
(931) 800-6400

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2271730Adult & Pediatric Dermatology Skin Solutions, PLLC
151 Ledford Mill Road, Tullahoma, TN 37388
Certificate of waiverNov 7, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20210305000266 TN Part B Supplier - Clinic/Group Practice 7618383290 Receives reassigned benefits from 1 practitioner
Practice locations: Tullahoma, TN

National Provider Directory

Locations

315 NW Atlantic St
Ste B
Tullahoma, TN 37388
Phone (931) 800-6400

151 Ledford Mill Rd
Tullahoma, TN 37388
Phone (931) 454-1955

Interoperability endpoints

  • Direct secure messaging: ahite@apdskinsolutions.emadirect.md

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant
Group: 193400000X SINGLE SPECIALTY GROUP
363AM0700X Yes

Addresses

Primary practice location

151 Ledford Mill Rd
Tullahoma, TN 37388-2278

Mailing address

PO Box 802
Tullahoma, TN 37388-0802
Phone (931) 800-6400

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address ahite@apdskinsolutions.emadirect.md Direct

Other providers in Tullahoma, TN

All providers in Tullahoma, TN · Medical Physician Assistant in Tennessee

Sources for this page

Verify at the official NPI Registry.