Organization Active NPI

Klinger & Marshall Dermatology, LLC

  • Dermatology Physician
  • Terrytown, LA
National Provider Identifier
1306284591
Registry record updated Jun 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
KLINGER & MARSHALL DERMATOLOGY, LLC
Practice address
2600 Belle Chasse Hwy
Suite 202
Terrytown, LA 70056-7156
Phone
(504) 319-2608
NPI assigned
Jun 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2014

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

Authorized official

Name
Stephen KlingerNPI 1356531677
Title
Owner
Phone
(504) 319-2608

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

2600 Belle Chasse Hwy
Suite 202
Terrytown, LA 70056-7156

Mailing address

2600 Belle Chasse Hwy
Suite 202
Terrytown, LA 70056-7156

Other identifiers 1

IdentifierTypeStateIssuer
DU1676OtherLARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130925000616 LA Part B Supplier - Clinic/Group Practice 0244474625 Receives reassigned benefits from 2 practitioners
Practice locations: Gretna, LA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2076183Klinger & Marshall Dermatology, LLC2600 Belle Chasse Highway, Suite 202, Gretna, LA 70056Provider-performed microscopyApr 13, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403654400000",
    "number": "1306284591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 BELLE CHASSE HWY",
            "address_2": "SUITE 202",
            "city": "TERRYTOWN",
            "state": "LA",
            "postal_code": "700567156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 BELLE CHASSE HWY",
            "address_2": "SUITE 202",
            "city": "TERRYTOWN",
            "state": "LA",
            "postal_code": "700567156",
            "telephone_number": "504-319-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLINGER & MARSHALL DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-10",
        "last_updated": "2014-06-25",
        "status": "A",
        "authorized_official_last_name": "KLINGER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-319-2608"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DU1676",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Terrytown, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.