NPIMap

Organization Active NPI

Hagerstown Derm and Skin Care

  • Nurse Practitioner
  • Hagerstown, MD
National Provider Identifier
1598199796
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R134352 Issued in MD
Legal business name
HAGERSTOWN DERM AND SKIN CARE
Practice address
1136 Opal CT
Hagerstown, MD 21740-5940
Phone
(240) 469-4835
Fax
(240) 469-4836
NPI assigned
Aug 25, 2013
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Johanna Fangmeyer, NPNPI 1689900417
Title
Owner
Phone
(240) 469-4835

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R134352 MD Primary

Addresses

Primary practice location

1136 Opal CT
Hagerstown, MD 21740-5940

Mailing address

13424 Pennsylvania Ave
Suite 101
Hagerstown, MD 21742-2658
Phone (301) 370-6688

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1377388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1598199796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13424 PENNSYLVANIA AVE",
            "address_2": "SUITE 101",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217422658",
            "telephone_number": "301-370-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 OPAL CT",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405940",
            "telephone_number": "240-469-4835",
            "fax_number": "240-469-4836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAGERSTOWN DERM AND SKIN CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-25",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FANGMEYER",
        "authorized_official_first_name": "JOHANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-469-4835",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R134352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.