Dermatologists of Southwestern Ohio, LLC.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

004150 Issued in OH

Legal business name

DERMATOLOGISTS OF SOUTHWESTERN OHIO, LLC.

Practice address

7691 5 Mile Rd
Suite 312
Cincinnati, OH 45230-4348

Phone

(513) 232-3332

Fax

(513) 232-9635

NPI assigned

Sep 6, 2015

Organization subpart

No

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

Authorized official

Name

John C. Lepage, M.D.

Title

Authorized Official

Phone

(937) 433-7536

Specialties & licenses 1

Addresses

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Dermatologists of Southwestern Ohio, LLC.

  • Dermatology Physician
  • Dayton, OH
  • NPI 1801819883
  NPPES parent name

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

{
    "created_epoch": "1441497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508112000000",
    "number": "1780052811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 FAR HILLS AVE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454292381",
            "telephone_number": "937-433-7536",
            "fax_number": "937-433-9612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7691 5 MILE RD",
            "address_2": "SUITE 312",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452304348",
            "telephone_number": "513-232-3332",
            "fax_number": "513-232-9635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGISTS OF SOUTHWESTERN OHIO, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-06",
        "last_updated": "2017-10-16",
        "status": "A",
        "authorized_official_last_name": "LEPAGE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "937-433-7536",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "004150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eleonore Deri-Sproull
• Betul Emine Derinkuyu, MD
• Britney Derisi, LISW-S
• Jennifer Jo Derka, OTR/L
• Michelle Derkson, CERTIFICATE
• Dermatology Associates of Cinti Inc
• Dermatology Specialists of Greater Cincinnati Inc
• Amanda S Dermody, SWT, QMHS
• Tara L Dermon
• Mariah L Dern, LPC

• Physician Assistant in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.