Albany Dermatology Clinic, PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

049451 Issued in GA

Legal business name

ALBANY DERMATOLOGY CLINIC, PA

Practice address

2709 Meredyth Dr
Suite 340
Albany, GA 31707-0222

Phone

(229) 883-1130

Fax

(229) 883-1153

NPI assigned

Sep 22, 2005

Last updated

Apr 12, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melinda F. Greenfield, DONPI 1841285723

Title

Physician

Phone

(407) 875-2080

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 1

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.

• Melinda Faye Greenfield, DO

  • Dermatology Physician
  • Ponte Vedra, FL
  • NPI 1841285723
  Authorized official Same address or phone

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460419200000",
    "number": "1295721512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SOUTHHALL LANE",
            "address_2": "SUITE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517172",
            "telephone_number": "407-875-2080",
            "fax_number": "407-650-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 MEREDYTH DR",
            "address_2": "SUITE 340",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317070222",
            "telephone_number": "229-883-1130",
            "fax_number": "229-883-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBANY DERMATOLOGY CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2016-04-12",
        "status": "A",
        "authorized_official_last_name": "GREENFIELD",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "407-875-2080",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "049451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300021798A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SECONDARY GRP #",
            "identifier": "GRP1577",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD GROUP #",
            "identifier": "CB2415",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Albany, GA
• Providers in Albany, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.