NPIMap

Organization Active NPI

Dermahealth Dermatology, PLLC

  • Dermatology Physician
  • Richland, WA
National Provider Identifier
1881835171
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD0046007 Issued in WA
Legal business name
DERMAHEALTH DERMATOLOGY, PLLC
Practice address
1305 Fowler Street
Suite 1C
Richland, WA 99352-4715
Phone
(509) 783-2004
Fax
(509) 783-1949
NPI assigned
Mar 16, 2009
Last updated
Apr 4, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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

Authorized official

Name
Michelle Mercer
Title
Office Manager
Phone
(509) 783-2004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD0046007 WA Primary

Addresses

Primary practice location

1305 Fowler Street
Suite 1C
Richland, WA 99352-4715

Mailing address

1305 Fowler Street
Suite 1C
Richland, WA 99352-4715
Phone (509) 783-2004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090320000583 WA Part B Supplier - Clinic/Group Practice 8729145677 Receives reassigned benefits from 14 practitioners
Practice locations: Richland, WA

National Provider Directory

National Provider Directory

Locations

8551 W Gage Blvd
Ste F
Kennewick, WA 99336
Phone (509) 783-2004

1295 Fowler St
#1B
Richland, WA 99352
Phone (509) 783-2004

1295 Fowler St
Ste 102
Richland, WA 99352
Phone (509) 783-2004

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459728000000",
    "number": "1881835171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 FOWLER STREET",
            "address_2": "SUITE 1C",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524715",
            "telephone_number": "509-783-2004",
            "fax_number": "509-783-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 FOWLER STREET",
            "address_2": "SUITE 1C",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524715",
            "telephone_number": "509-783-2004",
            "fax_number": "509-783-1949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMAHEALTH DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-16",
        "last_updated": "2016-04-04",
        "status": "A",
        "authorized_official_last_name": "MERCER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "509-783-2004"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD0046007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; 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.

Verify at the official NPI Registry.