Associates in Dermatology SC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

ASSOCIATES IN DERMATOLOGY SC

Practice address

1404 Eastland Drive
Suite 204
Bloomington, IL 61701-3532

Phone

(309) 662-8813

Fax

(309) 662-6835

NPI assigned

Oct 23, 2007

Last updated

May 24, 2024By 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

Jennifer Marie Fiorini

Title

Practice Manager

Phone

(309) 662-8813

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Practitioners 7

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.

• Thomas Richard Brander, MD

  • Dermatology Physician
  • Bloomington, IL
  • NPI 1598803330
  Medicare reassignment Care Compare group NPD
• Kali A Fever, APN, CNP

  • Family Nurse Practitioner
  • Bloomington, IL
  • NPI 1760764385
  Medicare reassignment Care Compare group NPD
• Erin S Redd, APN CNP

  • Nurse Practitioner
  • Bloomington, IL
  • NPI 1578711586
  Medicare reassignment Care Compare group NPD
• Lucy Nelson Wisdom, MD

  • Dermatology Physician
  • Bloomington, IL
  • NPI 1669510400
  Medicare reassignment Care Compare group NPD
• Nichole Christine Rave, PA-C

  • Dermatology Physician
  • Bloomington, IL
  • NPI 1386031045
  Medicare reassignment Care Compare group
• Audrey M Wilson, APN

  • Nurse Practitioner
  • Saint Peters, MO
  • NPI 1447081948

  IL

  Medicare reassignment NPD
• James Richard Seehafer, MD

  • Dermatology Physician
  • Bloomington, IL
  • NPI 1619015450
  NPD

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716508800000",
    "number": "1689863904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 EASTLAND DRIVE",
            "address_2": "SUITE 204",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013532",
            "telephone_number": "309-662-8813",
            "fax_number": "309-662-6835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 EASTLAND DRIVE",
            "address_2": "SUITE 204",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013532",
            "telephone_number": "309-662-8813",
            "fax_number": "309-662-6835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATES IN DERMATOLOGY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-23",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A",
        "authorized_official_last_name": "FIORINI",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "309-662-8813"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lily Arnold
• Carrie Arteaga
• Stacy Kristina Ash
• Ashley R. Dagner, LCPC, PLLC
• Asone Speech Therapy, PLLC
• Associates in Obstetrics & Gynecology SC
• Asta Care Center of Bloomington LLC
• Erin Dawn Astroth
• Christine Lyn Atchison, APN, FNP-C
• Ryan Aten

• Dermatology Physician in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.