Warthan Dermatology Dallas LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

WARTHAN DERMATOLOGY DALLAS LLC

Practice address

12222 Coit Rd Ste 200
Dallas, TX 75251-2302

Phone

(817) 923-8220

NPI assigned

Aug 16, 2023

Last updated

Aug 16, 2023By 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

Jaclyn Hill

Title

Practice Manager

Phone

(817) 923-8220

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Locations

Practitioners 2

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.

• Molly Mae Warthan, M.D.

  • Dermatology Physician
  • Fort Worth, TX
  • NPI 1073773867
  Medicare reassignment Care Compare group NPD
• Yasmin Amir, MD

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1740712363

  Single Specialty, TX

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1692144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692144000000",
    "number": "1598548257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5751 EDWARDS RANCH RD STE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094131",
            "telephone_number": "817-923-8220",
            "fax_number": "817-923-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12222 COIT RD STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512302",
            "telephone_number": "817-923-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARTHAN DERMATOLOGY DALLAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "817-923-8220"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1740712363",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1073773867",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shirley Warren, CRT
• Madison Warrick, CCC-SLP
• Matthew Warrick, MD
• Jordan Wartell
• Ryan Thomas Warth
• Dara Eileen Wartman, M.S. CCC-SLP
• James Warwick
• Natalie Paige Wash, LPC
• Regina Morris Wash, M. ED.
• Katherine Alison Washam, P.A.-C.

• Dermatology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.