Northeast Dermatology and Cosmetic Surgery Center

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

35078963 Issued in OH

Legal business name

NORTHEAST DERMATOLOGY AND COSMETIC SURGERY CENTER

Practice address

925 North Hamilton Road
Suite 100
Gahanna, OH 43230-4566

Phone

(614) 473-9519

Fax

(614) 473-9543

NPI assigned

Jul 31, 2006

Last updated

Nov 29, 2007By 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

Dr. Joel Bain Herron, M.D.NPI 1154323681

Title

Medical Director

Phone

(614) 473-9519

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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 7

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.

• Joel Bain Herron, MD

  • Dermatology Physician
  • Gahanna, OH
  • NPI 1154323681
  Medicare reassignment Care Compare group NPD Authorized official
• Stephanie L Cotell, M.D.

  • Dermatology Physician
  • Gahanna, OH
  • NPI 1922093459
  Medicare reassignment Care Compare group NPD
• Michael Todd McKelvey, MD

  • Dermatology Physician
  • Gahanna, OH
  • NPI 1063477008
  Medicare reassignment Care Compare group NPD
• Jeannie Hennessy, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Hershey, PA
  • NPI 1104043561

  OH

  Medicare reassignment Care Compare group NPD
• Kaitlin M Schupp, P.A.

  • Medical Physician Assistant
  • Gahanna, OH
  • NPI 1255616124
  Medicare reassignment Care Compare group
• Molly Nicole Verhoff, PA-C

  • Physician Assistant
  • Medina, OH
  • NPI 1609254192
  Medicare reassignment Care Compare group
• Lisa Lashawn Miller, APRN-CNP

  • Family Nurse Practitioner
  • Columbus, OH
  • NPI 1972792919
  Medicare reassignment NPD

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1609882836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 NORTH HAMILTON ROAD",
            "address_2": "SUITE 100",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432304566",
            "telephone_number": "614-473-9519",
            "fax_number": "614-473-9543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 NORTH HAMILTON ROAD",
            "address_2": "SUITE 100",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432304566",
            "telephone_number": "614-473-9519",
            "fax_number": "614-473-9543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST DERMATOLOGY AND COSMETIC SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "HERRON",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "BAIN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "614-473-9519",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35078963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan N. Njonjo
• Nkeng Health Care LLC
• Emmanuel Ngulefac Nkengeh, CNP, FNP
• Larry R. Nolan II, DO
• Scott A Norris, LMT
• Northeast Oral and Maxillofacial Surgery
• Northeast Oral and Maxillofacial Surgery
• Samantha Noth, PA-C
• John W Novotny Jr., DDS
• Nu Wave Acupuncture

• Dermatology Physician in Gahanna, OH
• Providers in Gahanna, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.