Dermatology and Skin Surgery Center-Newark LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

35-047090 Issued in OH

Legal business name

DERMATOLOGY AND SKIN SURGERY CENTER-NEWARK LLC

Practice address

71 S Terrace Ave
Newark, OH 43055-1355

Phone

(614) 595-0718

NPI assigned

Apr 1, 2011

Last updated

Apr 20, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Larry John Little, M.D.NPI 1669651816

Title

Owner

Phone

(614) 824-4258

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Practitioners 1

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.

• Larry J Little, MD

  • Dermatology Physician
  • Newark, OH
  • NPI 1669651816
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303257600000",
    "number": "1801185681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E DESHLER AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432062623",
            "telephone_number": "614-824-4258",
            "fax_number": "614-443-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 S TERRACE AVE",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551355",
            "telephone_number": "614-595-0718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY AND SKIN SURGERY CENTER-NEWARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-01",
        "last_updated": "2011-04-20",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-824-4258",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35-047090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teagan Demoss
• Vince Denbar
• Michael Reed Denius
• Mindy Dennis, LICDC/LPC
• Caroline Depriest
• James W Desapri
• Frances L. Deutschle, MSW, LISW
• Kaylin Sarah Dewese, BSW, LSW
• Sophyah Diack
• Kathleen Mary Diamond

• Dermatology Physician in Newark, OH
• Providers in Newark, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; 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.