Active NPI
Forefront Dermatology, S.C.
- Dermatology Physician
- Cedar Rapids, IA
National Provider Identifier
1760870851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Legal business name
- FOREFRONT DERMATOLOGY, S.C.
- Practice address
- 202 10TH Street, SW
Suite 290
Cedar Rapids, IA 52403 - Phone
- (920) 663-9016
- Fax
- (920) 684-1439
- NPI assigned
- Dec 26, 2014
- Last updated
- May 16, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Betsy J Wernli, MD
- Title
- President
- Phone
- (920) 482-0671
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | Primary |
Addresses
Primary practice location
202 10TH Street, SW
Suite 290
Cedar Rapids, IA 52403
Mailing address
801 York St
Manitowoc, WI 54220-4630
Phone (866) 630-9882
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130819000272 | IA | Part B Supplier - Clinic/Group Practice | 3779471701 |
Receives reassigned benefits from 28 practitioners 8 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Fort Madison, IA; West Burlington, IA; Ottumwa, IA; Newton, IA; Mount Pleasant, IA; Marion, IA; Iowa City, IA; Council Bluffs, IA… |
Other NPIs on the same Medicare enrollment 8
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Heartland Dermatology, A Forefront Dermatology Practice
- Dermatology Physician
- Clive, IA
- NPI 1477076628
O20130819000272
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419552000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1526428800000",
"number": "1760870851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 YORK ST",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542204630",
"telephone_number": "866-630-9882",
"fax_number": "920-682-5810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 10TH STREET, SW",
"address_2": "SUITE 290",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "52403",
"telephone_number": "920-663-9016",
"fax_number": "920-684-1439"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FOREFRONT DERMATOLOGY, S.C.",
"organizational_subpart": "NO",
"enumeration_date": "2014-12-26",
"last_updated": "2018-05-16",
"status": "A",
"authorized_official_last_name": "WERNLI",
"authorized_official_first_name": "BETSY",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "920-482-0671",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Rapids, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; 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.