North Florida Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME122956 Issued in FL

Legal business name

NORTH FLORIDA DERMATOLOGY LLC

Practice address

1722 SW Newland Way
Lake City, FL 32025-6915

Phone

(386) 344-6102

Fax

(386) 344-6103

NPI assigned

Jun 8, 2016

Organization subpart

No

Name

Kelly Tepedino, MDNPI 1619237369

Title

Owner

Phone

(386) 344-6102

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly Diane Tepedino, MD

  • Dermatology Physician
  • Lake City, FL
  • NPI 1619237369

  Dermatology, FL

  Medicare reassignment Care Compare group NPD Authorized official
• Daven Navnit Doshi, M.D.

  • Dermatology Physician
  • Ocala, FL
  • NPI 1972708329

  Dermatology, FL

  Medicare reassignment Care Compare group NPD
• Jessica Bell, PA-C

  • Physician Assistant
  • Lake City, FL
  • NPI 1619300944

  FL

  Medicare reassignment
• Hillary Bailey, DNP, APRN

  • Family Nurse Practitioner
  • Lake City, FL
  • NPI 1154869782
  NPD
• Spring Marie Cramer, APRN

  • Family Nurse Practitioner
  • Lake City, FL
  • NPI 1902030596
  NPD
• Jessica O'Sullivan Murray, PA-C

  • Physician Assistant
  • Lake City, FL
  • NPI 1710421425
  NPD
• Miguel Jose Tepedino, MD

  • Family Medicine Physician
  • Lake City, FL
  • NPI 1568544054
  NPD

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

CLIA laboratory certificates

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 7, 2024.

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1689023830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 530033",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303530033",
            "telephone_number": "386-344-6102",
            "fax_number": "386-344-6103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 SW NEWLAND WAY",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320256915",
            "telephone_number": "386-344-6102",
            "fax_number": "386-344-6103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH FLORIDA DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-08",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "TEPEDINO",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-344-6102",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME122956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Jo Nogle, MOT, OTR/L
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• North Florida Home Health Solutions Inc
• North Florida Medical Sales & Rentals Inc.

• All providers in Lake City, FL
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.