Organization Active NPI

Jennifer Nash, MD Dermatology Associates of Midland, PLC

Doing business as Dermatology Associates of Midland, PLC

  • Dermatology Physician
  • Midland, MI
National Provider Identifier
1629586268
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
JENNIFER NASH, MD DERMATOLOGY ASSOCIATES OF MIDLAND, PLC
Doing business as
Dermatology Associates of Midland, PLC
Practice address
2711 W Wackerly St
Midland, MI 48640-6922
Phone
(989) 837-6868
NPI assigned
Jan 17, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Authorized official

Name
Jennifer Nash, MDNPI 1194844324
Title
Physician
Phone
(989) 750-2641

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

2711 W Wackerly St
Midland, MI 48640-6922

Mailing address

2711 W Wackerly St
Midland, MI 48640-6922

Other names 1

  • Dermatology Associates of Midland, PLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180223001716 MI Part B Supplier - Clinic/Group Practice 1456611227 Receives reassigned benefits from 5 practitioners
Practice locations: Midland, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2024850Nash Dermatology2711 W Wackerly, Midland, MI 48640Provider-performed microscopyMay 24, 2027

National Provider Directory

National Provider Directory

Locations

2711 W Wackerly St
Midland, MI 48640
Phone (989) 837-6868

Practitioners & affiliated clinicians

Practitioners 5

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": "1516147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1629586268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 W WACKERLY ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406922",
            "fax_number": "989-837-6837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 W WACKERLY ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406922",
            "telephone_number": "989-837-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER NASH, MD DERMATOLOGY ASSOCIATES OF MIDLAND, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-17",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A",
        "authorized_official_last_name": "NASH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "989-750-2641",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology Associates of Midland, PLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.