Active NPI
Forefront Dermatology, S.C.
- Dermatology Physician
- Centerville, OH
National Provider Identifier
1891183059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Legal business name
- FOREFRONT DERMATOLOGY, S.C.
- Practice address
- 220 E Spring Valley Pike
Centerville, OH 45458-2653 - Phone
- (937) 438-3376
- Fax
- (937) 438-9424
- NPI assigned
- Dec 22, 2014
- Last updated
- Jul 3, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Betsy J Wernli, MD
- Title
- President
- Phone
- (920) 482-0671
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | Primary | ||
| Procedural Dermatology Physician | 207NS0135X |
Addresses
Primary practice location
220 E Spring Valley Pike
Centerville, OH 45458-2653
Mailing address
801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008
Other practice location 1
1149 Stone Dr Ste 100
Harrison, OH 45030-1676
Phone (513) 845-8120
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150402000858 | OH | Part B Supplier - Clinic/Group Practice | 3779471701 |
Receives reassigned benefits from 8 practitioners 2 other NPIs on this enrollment Practice locations: Centerville, OH; Columbus, OH; Harrison, OH |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 36D0685826 | Forefront Dermatology, SC | Provider-performed microscopy | Mar 31, 2028 |
| 36D2148750 | Forefront Dermatology, SC | Provider-performed microscopy | May 16, 2028 |
National Provider Directory
National Provider DirectoryLocations
400 N Main St
Ste D
Centerville, OH 45459
Phone (937) 438-3376
Practitioners & affiliated clinicians
Practitioners 9
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.
-
- Physician Assistant
- Harrison, OH
- NPI 1821702192
-
- Family Nurse Practitioner
- Centerville, OH
- NPI 1164299053
-
- Dermatology Physician
- Centerville, OH
- NPI 1356359517
-
- Physician Assistant
- Columbus, OH
- NPI 1982156402
-
- Dermatology Physician
- Columbus, OH
- NPI 1114131042
-
- Dermatology Physician
- Manitowoc, WI
- NPI 1437378973
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419206400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1688342400000",
"number": "1891183059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 YORK ST",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542204630",
"telephone_number": "920-663-9008",
"fax_number": "920-684-1439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 E SPRING VALLEY PIKE",
"city": "CENTERVILLE",
"state": "OH",
"postal_code": "454582653",
"telephone_number": "937-438-3376",
"fax_number": "937-438-9424"
}
],
"practiceLocations": [
{
"address_1": "1149 Stone Dr Ste 100",
"address_purpose": "LOCATION",
"city": "Harrison",
"state": "OH",
"postal_code": "450301676",
"country_code": "US",
"telephone_number": "513-845-8120",
"fax_number": "513-845-8121",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "FOREFRONT DERMATOLOGY, S.C.",
"organizational_subpart": "NO",
"enumeration_date": "2014-12-22",
"last_updated": "2023-07-03",
"certification_date": "2023-07-03",
"status": "A",
"authorized_official_last_name": "WERNLI",
"authorized_official_first_name": "BETSY",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "920-482-0671",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": true
},
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centerville, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.