Avenues Dermatology PLLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

0101059025 Issued in VA

Legal business name

AVENUES DERMATOLOGY PLLC

Practice address

420 Libbie Ave
Richmond, VA 23226-2616

Phone

(804) 288-4410

Fax

(804) 288-4458

NPI assigned

Mar 27, 2007

Organization subpart

No

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

Authorized official

Name

Laura S Phieffer, MDNPI 1508934423

Title

Owner

Phone

(804) 288-4410

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 5

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

• Laura Susanne Phieffer, MD

  • Dermatology Physician
  • Richmond, VA
  • NPI 1508934423
  Medicare reassignment Care Compare group NPD Authorized official
• Shannon Ann Chase, FNP

  • Family Nurse Practitioner
  • Richmond, VA
  • NPI 1306320759
  Medicare reassignment Care Compare group NPD
• Courtney Grizzard Kendall

  • Gerontology Nurse Practitioner
  • North Chesterfield, VA
  • NPI 1285110726
  Medicare reassignment Care Compare group NPD
• Elizabeth C Methven, PA-C

  • Physician Assistant
  • Richmond, VA
  • NPI 1881545358
  Medicare reassignment NPD
• Laura Elizabeth Regan, M.D.

  • Dermatology Physician
  • Midlothian, VA
  • NPI 1053474759
  NPD (past)

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382659200000",
    "number": "1699893388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 LIBBIE AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232262616",
            "telephone_number": "804-288-4410",
            "fax_number": "804-288-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 LIBBIE AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232262616",
            "telephone_number": "804-288-4410",
            "fax_number": "804-288-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVENUES DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2013-10-25",
        "status": "A",
        "authorized_official_last_name": "PHIEFFER",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-288-4410",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "VA",
            "license": "0101059025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO",
            "identifier": "1229850",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NON-HMO",
            "identifier": "7229207",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "187989",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Autry, AGACNP
• Autumn a Keener, M.Ed., Bcba, LLC
• Sarah Auvergne, PHD
• Av Community Connect
• Avanti Service Inc
• Mary C Averette, PTA
• Avery Partners, Inc
• Avery Partners, Inc.
• Tracey Lyn Avery-Geter, N.P.
• Melorah I Avery, DO

• Point of Service in Richmond, VA
• Providers in Richmond, VA by specialty
• Point of Service in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.