Catoma Dermatology, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

27325 Issued in AL

Legal business name

CATOMA DERMATOLOGY, LLC

Practice address

1300 Bridge Creek Dr. NE
Cullman, AL 35055

Phone

(256) 737-7546

Fax

(256) 841-6180

NPI assigned

May 15, 2014

Organization subpart

No

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

Authorized official

Name

Clancy H Johnson, MDNPI 1275591315

Title

Physician

Phone

(256) 737-7546

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

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

• Clancy Hagedorn Johnson, M.D.

  • Dermatology Physician
  • Cullman, AL
  • NPI 1275591315
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441238400000",
    "number": "1386055010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 BRIDGE CREEK DR. NE",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "35055",
            "telephone_number": "256-737-7546",
            "fax_number": "256-736-5848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 BRIDGE CREEK DR. NE",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "35055",
            "telephone_number": "256-737-7546",
            "fax_number": "256-841-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATOMA DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-15",
        "last_updated": "2015-09-03",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CLANCY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "256-737-7546",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "AL",
            "license": "27325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynndy Carson, RN
• Ronald Wilson Carter, DMD
• Cullen Seth Carver, OD
• Conrad Lane Cash, CRNP
• Catherine J Graham DMD LLC (S'more Smiles)
• Cary Kip Chambers, CRNA
• Donna Wilbanks Chamblee, ATC
• Melissa Vedette Chan, O.D.
• Kimberly L Chaney, CRNP
• Brandon Chatman

• Dermatology Physician in Cullman, AL
• Providers in Cullman, AL by specialty
• Dermatology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; 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.