Greater Des Moines Dermatology PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

33182 Issued in IA

Legal business name

GREATER DES MOINES DERMATOLOGY PC

Practice address

2424 128TH St
NW 128TH Street
Urbandale, IA 50323-1816

Phone

(515) 243-8676

Fax

(515) 243-0487

NPI assigned

Jul 18, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Garth Abrahamson, M.D.NPI 1245239623

Title

Ceo

Phone

(515) 243-8676

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

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

• FHIR API: https://fhir4.healow.com/fhir/r4/GGDCCA

Practitioners 4

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

• Timothy Garth Abrahamson, M.D.

  • Dermatology Physician
  • Urbandale, IA
  • NPI 1245239623
  Medicare reassignment Care Compare group NPD Authorized official
• Michelle Elise Greiman, FNP-C

  • Family Nurse Practitioner
  • Urbandale, IA
  • NPI 1982354817
  Medicare reassignment Care Compare group NPD
• Jacob Anthony Lorsung, PA-C

  • Dermatology Physician
  • Dubuque, IA
  • NPI 1861022568
  Medicare reassignment Care Compare group
• Molly Harris, FNP-C

  • Family Nurse Practitioner
  • Brentwood, TN
  • NPI 1720515448
  NPD

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1730188160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 128TH ST",
            "address_2": "NW 128TH STREET",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503231816",
            "telephone_number": "515-243-8676",
            "fax_number": "515-243-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 128TH ST",
            "address_2": "NW 128TH STREET",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503231816",
            "telephone_number": "515-243-8676",
            "fax_number": "515-243-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER DES MOINES DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-18",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "ABRAHAMSON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "GARTH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "515-243-8676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IA",
            "license": "33182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0255075",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chloe Ann Goodwin, DC
• Jeremy Lawson Grace
• Brian Joseph Graf, DPT
• Barbara J Graham, LISW
• Grateful-Place LLC
• Greenfield Support Services LLC
• Maleah Greenslade
• Kimberlee Gregory, LISW
• Michelle Elise Greiman, FNP-C
• John C Greiner, PHARMD

• Dermatology Physician in Urbandale, IA
• Providers in Urbandale, IA by specialty
• Dermatology Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.