Individual provider Active NPI

Heather N Demory, PA-C

  • Physician Assistant
  • Frederick, MD
National Provider Identifier
1508911850
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0002586 Issued in MD
Practice address
77 Thomas Johnson Dr Ste C
Frederick, MD 21702-4893
Phone
(301) 668-3004
Fax
(301) 668-3005
NPI assigned
Jan 25, 2007
Last updated
Oct 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C0002586 MD
Physician Assistant 363A00000X C0002586 MD Primary

Addresses

Primary practice location

77 Thomas Johnson Dr Ste C
Frederick, MD 21702-4893

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other practice location 1

112 Thomas Johnson Dr Ste 130
Frederick, MD 21702-4377
Phone (301) 668-3004

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address Heather.Demory@forefrontdermatology.emadirect.md
Direct Messaging Address Heather.Demory@forefrontdermatology.emadirect.md

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130531000145 MD Practitioner - Physician Assistant 1456599539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forefront Dermatology SCGroup PAC ID 3779471701, 650 clinicians

Practice addresses (Care Compare)

112 Thomas Johnson Dr
Suite 130
Frederick, MD 21702-4377
Phone (301) 668-3004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
C0002586MDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Dermatology, S.C. CurrentSince Mar 30, 2021 Accepting new patients
Peninsula Dermatology Associates,P.a. Current Accepting new patients
Forefront Dermatology SC CurrentSince Mar 30, 2021 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

112 Thomas Johnson Dr
Ste 130
Frederick, MD 21702
Phone (301) 668-3004

77 Thomas Johnson Dr
Ste C
Frederick, MD 21702
Phone (301) 668-3004

106 Milford St
Ste 301
Salisbury, MD 21804
Phone (410) 546-4431

106 Milford St
Ste 302
Salisbury, MD 21804
Phone (410) 546-4431

801 York St
Manitowoc, WI 54220
Phone (866) 630-9882

Interoperability endpoints

  • Direct secure messaging: heather.demory@forefrontdermatology.emadirect.md

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1508911850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 THOMAS JOHNSON DR STE C",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024893",
            "telephone_number": "301-668-3004",
            "fax_number": "301-668-3005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Thomas Johnson Dr Ste 130",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024377",
            "country_code": "US",
            "telephone_number": "301-668-3004",
            "fax_number": "301-668-3005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEMORY",
        "first_name": "HEATHER",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0002586",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0002586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Heather.Demory@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "77 Thomas Johnson Dr Ste C",
            "city": "Frederick",
            "state": "MD",
            "country_code": "US",
            "postal_code": "217024893",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Heather.Demory@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "112 Thomas Johnson Dr Ste 130",
            "city": "Frederick",
            "state": "MD",
            "country_code": "US",
            "postal_code": "217024377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.