Dermatology Consultants Midwest P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

3992 Issued in KS

Legal business name

DERMATOLOGY CONSULTANTS MIDWEST P.A.

Practice address

10777 Nall Ave Ste 220
Overland Park, KS 66211-1231

Phone

(913) 469-0110

Fax

(913) 469-6579

NPI assigned

Aug 15, 2006

Organization subpart

No

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

Authorized official

Name

David M O'Connell, MD

Title

President

Phone

(913) 469-0110

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

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

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00087

Practitioners 3

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

• Emilie Dore Badje, M.D.

  • Dermatology Physician
  • Overland Park, KS
  • NPI 1780062901

  KS, Single Specialty

  Medicare reassignment Care Compare group NPD
• Rebecca Leigh Chain, M.D.

  • Dermatology Physician
  • Overland Park, KS
  • NPI 1376786780

  KS

  Medicare reassignment Care Compare group NPD
• Braden Ray Rance, M.D.

  • Dermatology Physician
  • Overland Park, KS
  • NPI 1891767562

  KS

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1497768774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10777 NALL AVE, SUITE 220",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111231",
            "telephone_number": "913-469-0110",
            "fax_number": "913-469-6579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10777 NALL AVE STE 220",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662111231",
            "telephone_number": "913-469-0110",
            "fax_number": "913-469-6579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY CONSULTANTS MIDWEST P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "O'CONNELL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "913-469-0110",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "KS",
            "license": "3992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth A Depriest, CRNA
• Depth KC LLC
• Justin Chong Der, LPC
• Athena Nicole Dericotte, RBT
• Derm Hair Center
• Andrea Jett Dermyer, LCMFT
• Eric Deroo, MD
• Megan Derosa, RBT
• Stephanie Elizabeth Deruy, DPT
• Michaela Dervin

• All providers in Overland Park, KS
• Specialist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; 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.