Renewal Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

RENEWAL DERMATOLOGY PLLC

Practice address

7512 Gardner Park Dr
Gainesville, VA 20155-3414

Phone

(703) 753-9860

Fax

(703) 753-9863

NPI assigned

Jun 21, 2011

Last updated

Jun 21, 2011By 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

Joanne Gutliph, MD

Title

President

Phone

(571) 261-2885

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308614400000",
    "number": "1619263407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7512 GARDNER PARK DR",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553414",
            "telephone_number": "703-753-9860",
            "fax_number": "703-753-9863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7512 GARDNER PARK DR",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553414",
            "telephone_number": "703-753-9860",
            "fax_number": "703-753-9863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEWAL DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-21",
        "last_updated": "2011-06-21",
        "status": "A",
        "authorized_official_last_name": "GUTLIPH",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "571-261-2885",
        "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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jack Reiter, DC
• Jodi Marie Remsen, PT
• Renal Treatment Centers Mid Atlantic Inc (Haymarket Dialysis)
• Renew Counseling and Services
• Renewal Dermatology & Medspa, P.C.
• Renewal Dermatology PLLC
• Melissa Anna Restrepo, D.M.D
• Results Rehab & Fitness, Inc
• Audra Reynolds, PSY.D.
• Christine Marie Reynolds, MSSW, LCSW

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

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