Dermatology Associates of Siouxland, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

31906 Issued in IA

Legal business name

DERMATOLOGY ASSOCIATES OF SIOUXLAND, PC

Practice address

2930 Hamilton Blvd
Ste. 102
Sioux City, IA 51104-2425

Phone

(712) 277-9370

Fax

(712) 252-4733

NPI assigned

Mar 8, 2007

Last updated

Aug 17, 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

J. Mark Demay, M.D.

Title

Dermatologist

Phone

(712) 277-9370

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Drs. Rossiter & Demay, LLP Former legal business name

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 3

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.

• John Mark Demay, MD

  • Dermatology Physician
  • Sioux City, IA
  • NPI 1366447294
  Medicare reassignment Care Compare group NPD
• Avery Grace Macintosh

  • Physician Assistant
  • Mahtomedi, MN
  • NPI 1609633510

  IA

  Medicare reassignment Care Compare group NPD
• David J. Grote, PA

  • Medical Physician Assistant
  • Sioux City, IA
  • NPI 1164465019
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471392000000",
    "number": "1417088907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2930 HAMILTON BLVD",
            "address_2": "STE. 102",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511042425",
            "telephone_number": "712-277-9370",
            "fax_number": "712-252-4733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 HAMILTON BLVD",
            "address_2": "STE. 102",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511042425",
            "telephone_number": "712-277-9370",
            "fax_number": "712-252-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES OF SIOUXLAND, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2016-08-17",
        "status": "A",
        "authorized_official_last_name": "DEMAY",
        "authorized_official_first_name": "J. MARK",
        "authorized_official_title_or_position": "DERMATOLOGIST",
        "authorized_official_telephone_number": "712-277-9370",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IA",
            "license": "31906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BLUE CROSS & BLUE SHIELD GROUP NPI",
            "identifier": "1417088907",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "IB2763",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR GROUP PTAN",
            "identifier": "DT7736",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drs. Rossiter & Demay, LLP",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• John Mark Demay, MD
• Colette Demoss, PA-C
• Glenda F. Denherder, APRN
• Rebecca Denton, FNP-C
• Bonnie L Derby, L.C.S.W.
• Lisa Derocher, RN
• Melissa Deroos, CADC
• Annemarie Jean Desanto, DMD
• Avery Nicole Desy
• Haley Devries

• Specialist in Sioux City, IA
• Providers in Sioux City, IA by specialty
• Specialist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.