Forefront Dermatology SC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

FOREFRONT DERMATOLOGY SC

Practice address

3025 Hamaker CT Ste 340
Fairfax, VA 22031-2237

Phone

(703) 849-8036

Fax

(703) 204-3448

NPI assigned

Jul 22, 2024

Last updated

Jul 22, 2024By 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

Betsy J Wernli, MDNPI 1437378973

Title

President

Phone

(920) 663-9008

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Vienna, VA
  • NPI 1891169975

  O20160421001476

  Same enrollment
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Bethesda, MD
  • NPI 1518480136

  O20160421001476

  Same enrollment

Tax ID family

Dba Advanced Dermatology121 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 3

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Forefront Dermatology SC

  dba dba RidgeView Dermatology, A Forefront Dermatology Practice

  • Dermatology Physician
  • Farmville, VA
  • NPI 1760206437
  NPD tax ID
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Virginia Beach, VA
  • NPI 1003787748
  NPD tax ID
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Suffolk, VA
  • NPI 1619760022
  NPD tax ID

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.

• Betsy Jane Wernli, M.D

  • Dermatology Physician
  • Manitowoc, WI
  • NPI 1437378973
  Authorized official Same address or phone
• Abigail Park Lee Shaw, PA-C

  • Physician Assistant
  • Vienna, VA
  • NPI 1770213670
  NPD

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1609604610",
    "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": "3025 HAMAKER CT STE 340",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312237",
            "telephone_number": "703-849-8036",
            "fax_number": "703-204-3448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREFRONT DERMATOLOGY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "WERNLI",
        "authorized_official_first_name": "BETSY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-663-9008",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sabrina Ford
• Erin Foreman
• Rebecca Forer, LCSW
• Mohammad Shahim Formoly, CSA
• Jonathan Filip Forney
• Carol Ann Forrest

• Dermatology Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.