Comprehensive Dermatology PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

01051097 Issued in IN

Legal business name

COMPREHENSIVE DERMATOLOGY PC

Doing business as

Comprehensive Dermatology

Practice address

8244 E US Highway 36
Ste 1220
Avon, IN 46123-9575

Phone

(317) 272-1366

Fax

(317) 272-1388

NPI assigned

Sep 22, 2005

Organization subpart

No

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

Authorized official

Name

David Levi Nathan, MDNPI 1619963998

Title

President

Phone

(317) 272-1366

Specialties & licenses 1

Addresses

Other names 1

• Comprehensive Dermatology Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

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

Interoperability endpoints

• Direct secure messaging: drnathan@compderm.azalea.phimailbox.com

Practitioners 1

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

• David Levi Nathan, MD

  • Dermatology Physician
  • Avon, IN
  • NPI 1619963998
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197936000000",
    "number": "1689660946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8244 E US HIGHWAY 36",
            "address_2": "STE 1220",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461239575",
            "telephone_number": "317-272-1366",
            "fax_number": "317-272-1388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8244 E US HIGHWAY 36",
            "address_2": "STE 1220",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461239575",
            "telephone_number": "317-272-1366",
            "fax_number": "317-272-1388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2007-12-18",
        "status": "A",
        "authorized_official_last_name": "NATHAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LEVI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-272-1366",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01051097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comprehensive Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dermatology Physician in Avon, IN
• Providers in Avon, IN by specialty
• Dermatology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.