Southern Dermatology of New Orleans

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

SOUTHERN DERMATOLOGY OF NEW ORLEANS

Practice address

2633 Napoleon Ave Ste 1020
New Orleans, LA 70115-7403

Phone

(504) 891-8004

Fax

(504) 891-8005

NPI assigned

Jan 14, 2019

Organization subpart

No

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

Authorized official

Name

Ms. Katy Wiltz, MDNPI 1619168846

Title

Owner

Phone

(504) 891-8004

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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 2

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

• Katy Wiltz, MD

  • Dermatology Physician
  • New Orleans, LA
  • NPI 1619168846
  Medicare reassignment Care Compare group NPD Authorized official
• Elizabeth Aline Williamson, MD

  • Dermatology Physician
  • New Orleans, LA
  • NPI 1558757898
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1547424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617580800000",
    "number": "1851865869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 PALMER AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701186240",
            "telephone_number": "504-891-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 NAPOLEON AVE STE 1020",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701157403",
            "telephone_number": "504-891-8004",
            "fax_number": "504-891-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DERMATOLOGY OF NEW ORLEANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-14",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "WILTZ",
        "authorized_official_first_name": "KATY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-891-8004",
        "authorized_official_name_prefix": "Ms.",
        "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": []
}

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• Southern Orthopaedic Specialists Apmc
• Southern Psychological Specialists LLC
• Southern Surgical Solutions
• Southern Wellness PHS LLC

• Dermatology Physician in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Dermatology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.