The Dermatology Clinic of St Tammany II, LLC

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

08440 52 06 Issued in LA

Legal business name

THE DERMATOLOGY CLINIC OF ST TAMMANY II, LLC

Doing business as

Grieshaber Dermatology

Practice address

714 W 16TH Ave
Covington, LA 70433-2422

Phone

(985) 893-1035

Fax

(985) 893-1058

NPI assigned

Oct 17, 2006

Last updated

Dec 5, 2019By 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

Dr. Emily Katherine Grieshaber, MDNPI 1265605158

Title

Manager

Phone

(985) 893-1035

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Grieshaber Dermatology Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 4

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.

• Emily Katherine Grieshaber, M.D.

  • Dermatology Physician
  • Covington, LA
  • NPI 1265605158
  Medicare reassignment Care Compare group Authorized official
• Kristen Bice, MD

  • Dermatology Physician
  • Covington, LA
  • NPI 1619339579
  Medicare reassignment Care Compare group NPD
• Robert J Grieshaber, MD

  • Dermatology Physician
  • Covington, LA
  • NPI 1881731222
  Medicare reassignment Care Compare group
• Alan Gregory Crawford, PA

  • Dermatology Physician
  • Ocean Springs, MS
  • NPI 1720048002

  LA

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575504000000",
    "number": "1356421010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 W 16TH AVE",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704332422",
            "telephone_number": "985-893-1035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 W 16TH AVE",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704332422",
            "telephone_number": "985-893-1035",
            "fax_number": "985-893-1058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "630 S Tyler St",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "LA",
            "postal_code": "704333346",
            "country_code": "US",
            "telephone_number": "985-893-1035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE DERMATOLOGY CLINIC OF ST TAMMANY II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2019-12-05",
        "status": "A",
        "authorized_official_last_name": "GRIESHABER",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "KATHERINE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "985-893-1035",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "LA",
            "license": "08440 52 06",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1054810",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grieshaber Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grieshaber Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Caycee Chayne Terrell-Vining, M.ED., LPC, NCC, DCC
• Colby Terry
• Texas Digestive Disease Consultants PLLC
• Texas Neuro Physiological Associates, P.a.
• Texas Teleneuromonitoring Serivces, PA
• The Family Practice at Northshore Counseling and Wellness, LLC
• The Foodbank of Covington, Louisiana, Inc. (All Saints Dental Clinic)
• The Great Atlantic and Pacific Tea Company Inc (Sav a Center Pharmacy)
• The Movement Science Center
• The Natural Birthhouse - Northshore

• Procedural Dermatology Physician in Covington, LA
• Providers in Covington, LA by specialty
• Procedural Dermatology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; 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.