High Tide Dermatology Center LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME106898 Issued in FL

Legal business name

HIGH TIDE DERMATOLOGY CENTER LLC

Practice address

221 Harbour Dr
Naples, FL 34103-4027

Phone

(443) 871-2407

NPI assigned

Aug 19, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Debra Lynn Bailey, M.D.NPI 1285622852

Title

President

Phone

(443) 871-2407

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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

• Debra L Bailey, M.D.

  • Dermatology Physician
  • Naples, FL
  • NPI 1285622852
  Medicare reassignment Care Compare group NPD Authorized official
• Melanie Stover, PA-C

  • Physician Assistant
  • Naples, FL
  • NPI 1346302338
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1408406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408406400000",
    "number": "1306245980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 HARBOUR DR",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341034027",
            "telephone_number": "443-871-2407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 HARBOUR DR",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341034027",
            "telephone_number": "443-871-2407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGH TIDE DERMATOLOGY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-19",
        "last_updated": "2014-08-19",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "443-871-2407",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME106898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Hicks, APRN
• Dennis Hidlebaugh, MD
• Elizabeth Hidlebaugh, MD
• Erik Douglas Hiester, DO
• Karen L Hiester, DO
• Dean Boyd Hildahl, M.D.
• Hiler Chiropractic PA
• Richard A. Hiler, D.C.
• Deborah Hill, ARNP
• Samuel L Hill III, M.D.

• Dermatology Physician in Naples, FL
• Providers in Naples, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; 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.