Dermatology Associates of Dothan, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

8834 Issued in AL

Legal business name

DERMATOLOGY ASSOCIATES OF DOTHAN, LLC

Practice address

101 Professional LN
Enterprise, AL 36330-2085

Phone

(334) 347-3404

Fax

(334) 671-0322

NPI assigned

Jan 27, 2011

Last updated

Jan 27, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

DERMATOLOGY ASSOCIATES OF DOTHANAs reported in NPPES

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

Authorized official

Name

Dr. Terry L Pynes, MD

Title

Owner

Phone

(334) 793-9222

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dermatology Associates of Dothan Other name

Part of

Dermotology a

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Dermatology Associates of Dothan, LLC

  dba Dermatology Associates of Dothan

  • Dermatology Physician
  • Dothan, AL
  • NPI 1255466330
  NPPES parent name

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.

• Patrick S Nelson, PA-C

  • Physician Assistant
  • Dothan, AL
  • NPI 1295067643
  NPD

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

{
    "created_epoch": "1296086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296086400000",
    "number": "1538465323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2431 W MAIN ST STE 501",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363011274",
            "telephone_number": "334-793-9222",
            "fax_number": "334-671-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PROFESSIONAL LN",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302085",
            "telephone_number": "334-347-3404",
            "fax_number": "334-671-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES OF DOTHAN, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DERMATOLOGY ASSOCIATES OF DOTHAN",
        "enumeration_date": "2011-01-27",
        "last_updated": "2011-01-27",
        "status": "A",
        "authorized_official_last_name": "PYNES",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-793-9222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "8834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529932951",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "51007184",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology Associates of Dothan",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Specialist in Enterprise, AL
• Providers in Enterprise, AL by specialty
• Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; 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.