Wheatland Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

35120090 Issued in OH

Legal business name

WHEATLAND DERMATOLOGY LLC

Practice address

1050 East Greenville Rd
St Marys, OH 45885-4588

Phone

(419) 394-3331

Fax

(419) 394-3330

NPI assigned

May 7, 2015

Last updated

Jan 9, 2023By 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

Suzanne Quinter, MDNPI 1376717967

Title

Owner

Phone

(419) 290-8672

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 8

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.

• Suzanne Dietz Quinter, MD

  • Dermatology Physician
  • Saint Marys, OH
  • NPI 1376717967
  Medicare reassignment NPD Authorized official
• Audrey H. Jones, FNP-C

  • Nurse Practitioner
  • Lima, OH
  • NPI 1992229850

  Dermatology

  Medicare reassignment NPD
• Kimberly Lynn Sadler, APRN CNP

  • Family Nurse Practitioner
  • Saint Marys, OH
  • NPI 1235620956
  Medicare reassignment NPD
• Lauren Bender, PA-C

  • Physician Assistant
  • Saint Marys, OH
  • NPI 1689173312
  Medicare reassignment
• Andrea E Knapke, PA-C

  • Physician Assistant
  • Saint Marys, OH
  • NPI 1417149675
  Medicare reassignment
• Kenneth Lance Bryant, DO

  • Surgery Physician
  • Saint Marys, OH
  • NPI 1821007949
  NPD (past)
• Robert D Keighley, D.O.

  • Surgery Physician
  • Dayton, OH
  • NPI 1053320176
  NPD (past)
• James Anthony Reichert, D.O.

  • Surgery Physician
  • Celina, OH
  • NPI 1659543403
  NPD (past)

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

{
    "created_epoch": "1430956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1477931608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 EAST GREENVILLE RD",
            "city": "ST MARYS",
            "state": "OH",
            "postal_code": "458852622",
            "telephone_number": "419-394-3331",
            "fax_number": "419-394-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 EAST GREENVILLE RD",
            "city": "ST MARYS",
            "state": "OH",
            "postal_code": "458854588",
            "telephone_number": "419-394-3331",
            "fax_number": "419-394-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHEATLAND DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-07",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-06",
        "status": "A",
        "authorized_official_last_name": "QUINTER",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-290-8672",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35120090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amanda R Wellman, L. AC.
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• Melissa Jane Weston, DPT
• Dane B Widner, DDS
• Kimberly Wiener, NP-C
• Wilson Orthopedic and Sports PT
• Michelle Wilson, SLP
• Nicholas D Wilson, PT

• Dermatology Physician in Saint Marys, OH
• Providers in Saint Marys, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.