Derm Consults Online PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

0101039759 Issued in VA

Legal business name

DERM CONSULTS ONLINE PC

Practice address

1350 Beverly Rd Suite 115-209
McLean, VA 22101

Phone

(703) 606-0682

Fax

(703) 524-7245

NPI assigned

Feb 19, 2013

Organization subpart

No

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

Authorized official

Name

Michelle Rivera, MD

Title

President

Phone

(703) 606-0682

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1361232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361232000000",
    "number": "1649510298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 BEVERLY RD SUITE 115-209",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "22101",
            "telephone_number": "703-606-0682",
            "fax_number": "703-524-7245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 BEVERLY RD SUITE 115-209",
            "city": "MCLEAN",
            "state": "VA",
            "postal_code": "22101",
            "telephone_number": "703-606-0682",
            "fax_number": "703-524-7245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERM CONSULTS ONLINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-19",
        "last_updated": "2013-02-19",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-606-0682",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101039759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dental Care of McLean & Associates PLLC
• Dental Center of Tyson's Corner
• Dentalia PLLC
• Jeremiah J Depue, M.D.
• Stephanie Der, OTS
• Dermatology Associates of McLean
• Michael Stuart Derose, D.C.
• Stacey Lynn Dershewitz, PSY.D.
• Nicholas Desantis, DC
• Revati Shashank Deshpande

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; 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.