Tulane Dermatology Affiliates

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

TULANE DERMATOLOGY AFFILIATES

Practice address

1245 42ND Avenue
Gulfport, MS 39501

Phone

(228) 864-8049

Fax

(228) 864-7655

NPI assigned

Sep 27, 2007

Organization subpart

No

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

Authorized official

Name

Patricia E. Depreo

Title

Office Manager

Phone

(228) 864-8049

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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 4

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

• Gwendolyn Ann Crane, M.D.

  • Dermatology Physician
  • Gulfport, MS
  • NPI 1417971094
  Medicare reassignment Care Compare group NPD
• Alan Lewis, MD

  • Dermatology Physician
  • Gulfport, MS
  • NPI 1912090143
  Medicare reassignment Care Compare group NPD
• Joseph P. Shrum, MD

  • Dermatology Physician
  • Gulfport, MS
  • NPI 1417040213
  Medicare reassignment NPD
• Martin Lewis Johnson, M.D.

  • Dermatology Physician
  • Hot Springs, AR
  • NPI 1225023773
  NPD (past)

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291161600000",
    "number": "1821285438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 42ND AVENUE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39501",
            "telephone_number": "228-864-8049",
            "fax_number": "228-864-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 42ND AVENUE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39501",
            "telephone_number": "228-864-8049",
            "fax_number": "228-864-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TULANE DERMATOLOGY AFFILIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2010-12-01",
        "status": "A",
        "authorized_official_last_name": "DEPREO",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "228-864-8049"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Dang Truong, PT, DPT, OCS
• Thy Truong, LCSW
• Joanna M. Trus, M.D.
• Trusted Hands Transportation LLC
• Anne Romig Tucker, APRN
• Pamela Tuli, MD
• Bobby W Tullos, M.D.
• Cynthia Tuminello, CRNA
• Erica Lynn Turan, FNP-C
• Tony Alexander Turan, FNP-C

• Dermatology Physician in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Dermatology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; 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.