Dermatology Specialists Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY SPECIALISTS INC

Practice address

12105 Bridgeton Square Drive
Bridgeton, MO 63044-2616

Phone

(314) 291-2588

Fax

(314) 291-4104

NPI assigned

Dec 4, 2006

Last updated

May 28, 2008By 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

Bruce J Hookerman, MDNPI 1396811105

Title

President

Phone

(314) 291-2588

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00091

Practitioners 1

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.

• Bruce J Hookerman, MD

  • Dermatology Physician
  • Bridgeton, MO
  • NPI 1396811105
  Authorized official Same address or phone

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211932800000",
    "number": "1427116680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12105 BRIDGETON SQUARE DRIVE",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442616",
            "telephone_number": "314-291-2588",
            "fax_number": "314-291-4104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12105 BRIDGETON SQUARE DRIVE",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442616",
            "telephone_number": "314-291-2588",
            "fax_number": "314-291-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY SPECIALISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2008-05-28",
        "status": "A",
        "authorized_official_last_name": "HOOKERMAN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-291-2588",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202820213",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Dermatology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.