Advanced Dermatology of the Midlands PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

ADVANCED DERMATOLOGY OF THE MIDLANDS PC

Practice address

12910 Pierce St Ste 120
Omaha, NE 68144-1106

Phone

(402) 933-3770

Fax

(402) 933-3633

NPI assigned

Oct 10, 2013

Last updated

Feb 6, 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

James M. Shehan, MD, FAADNPI 1316041734

Title

President

Phone

(402) 933-3770

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NE, IA2 enrollments

Enrollment records 2

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

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9691/brand/1/csg/1/fhir/r4

Practitioners 9

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.

• James M. Shehan, M.D.

  • Dermatology Physician
  • Omaha, NE
  • NPI 1316041734

  IA

  Medicare reassignment Care Compare group Authorized official
• Sally J Campbell, PA-C

  • Physician Assistant
  • Omaha, NE
  • NPI 1134628217

  IA

  Medicare reassignment Care Compare group
• Abbey Christensen, PA-C

  • Physician Assistant
  • Omaha, NE
  • NPI 1558820084

  IA

  Medicare reassignment Care Compare group
• Mathew Alan Davey, M.D.

  • Dermatology Physician
  • Omaha, NE
  • NPI 1851568703

  IA

  Medicare reassignment Care Compare group
• Rachel R. Person, APRN

  • Dermatology Physician
  • Omaha, NE
  • NPI 1841673738

  IA

  Medicare reassignment Care Compare group
• Jacob James Ridder, PA-C

  • Medical Physician Assistant
  • Omaha, NE
  • NPI 1508291717

  IA

  Medicare reassignment Care Compare group
• Sara Stephenson, PA-C

  • Dermatology Physician
  • Omaha, NE
  • NPI 1730453200

  IA

  Medicare reassignment Care Compare group
• Jonathan L. Spencer, M.D.

  • Pulmonary Disease Physician
  • Lincoln, NE
  • NPI 1538163241
  NPD (past)
• Louis A.D. Violi, M.D.

  • Pulmonary Disease Physician
  • Lincoln, NE
  • NPI 1922002633
  NPD (past)

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

{
    "created_epoch": "1381363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549411200000",
    "number": "1497182273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 GRAND AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503125305",
            "telephone_number": "515-237-3974",
            "fax_number": "515-883-2692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12910 PIERCE ST STE 120",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681441106",
            "telephone_number": "402-933-3770",
            "fax_number": "402-933-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DERMATOLOGY OF THE MIDLANDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-10",
        "last_updated": "2019-02-06",
        "status": "A",
        "authorized_official_last_name": "SHEHAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-933-3770",
        "authorized_official_credential": "MD, FAAD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100263840-00",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497182273",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Advanced Endodontic Therapy, PC (Advanced Endodontic Therapy)
• Advanced Family Eyecare PC
• Advanced Foot & Ankle LLC
• Advanced Foot & Ankle PC
• Advanced Home Health Care and Nursing, LLC

• Dermatology Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Dermatology Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.