NPIMap

Organization Active NPI

Annapolis Dermatology Center, PA

  • Dermatology Physician
  • Annapolis, MD
National Provider Identifier
1700995974
Registry record updated Jul 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
D0053350 Issued in MD
Legal business name
ANNAPOLIS DERMATOLOGY CENTER, PA
Practice address
71 Old Mill Bottom Rd N
Suite 300
Annapolis, MD 21409-5431
Phone
(410) 268-3877
Fax
(410) 268-8171
NPI assigned
Aug 30, 2006
Last updated
Jul 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2016

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

Authorized official

Name
Beth G Diamond, MDNPI 1598753097
Title
President
Phone
(410) 268-3887

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X D0053350 MD Primary

Addresses

Primary practice location

71 Old Mill Bottom Rd N
Suite 300
Annapolis, MD 21409-5431

Mailing address

71 Old Mill Bottom Rd N
Suite 300
Annapolis, MD 21409-5431
Phone (410) 268-3877

Other identifiers 1

IdentifierTypeStateIssuer
CH6676MedicaidMD

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D0955128Annapolis Dermatology Center71 Old Mill Bottom Rd North Ste 300, Annapolis, MD 21409ComplianceMar 18, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467936000000",
    "number": "1700995974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 OLD MILL BOTTOM RD N",
            "address_2": "SUITE 300",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214095431",
            "telephone_number": "410-268-3877",
            "fax_number": "410-268-8171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 OLD MILL BOTTOM RD N",
            "address_2": "SUITE 300",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214095431",
            "telephone_number": "410-268-3877",
            "fax_number": "410-268-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNAPOLIS DERMATOLOGY CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-07-08",
        "status": "A",
        "authorized_official_last_name": "DIAMOND",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-268-3887",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D0053350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH6676",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.