Active NPI
Bay Dermatology Associates Jerry L Hedrick MD PA
- Dermatology Physician
- Brandon, FL
National Provider Identifier
1891728861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- ME38730
- Legal business name
- BAY DERMATOLOGY ASSOCIATES JERRY L HEDRICK MD PA
- Practice address
- 500 Vonderburg Drive
Ste 115W
Brandon, FL 33511-5969 - Phone
- (813) 685-0306
- Fax
- (813) 651-1026
- NPI assigned
- Jul 10, 2006
- 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
- Jerry Leo Hedrick, MD PA
- Title
- Physician
- Phone
- (813) 685-0306
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | ME38730 | FL | Primary |
Addresses
Primary practice location
500 Vonderburg Drive
Ste 115W
Brandon, FL 33511-5969
Mailing address
500 Vonderburg Drive
Ste 115W
Brandon, FL 33511-5969
Phone (813) 685-0306
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0667336 | Other | FL | AETNA |
| 30425 | Other | FL | BLUE CROSS BLUE SHIELD |
| 070000215 | Other | FL | RAILROAD MEDICARE |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1263513600000",
"number": "1891728861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 VONDERBURG DRIVE",
"address_2": "STE 115W",
"city": "BRANDON",
"state": "FL",
"postal_code": "335115969",
"telephone_number": "813-685-0306",
"fax_number": "813-651-1026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 VONDERBURG DRIVE",
"address_2": "STE 115W",
"city": "BRANDON",
"state": "FL",
"postal_code": "335115969",
"telephone_number": "813-685-0306",
"fax_number": "813-651-1026"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BAY DERMATOLOGY ASSOCIATES JERRY L HEDRICK MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-10",
"last_updated": "2010-01-15",
"status": "A",
"authorized_official_last_name": "HEDRICK",
"authorized_official_first_name": "JERRY",
"authorized_official_middle_name": "LEO",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "813-685-0306",
"authorized_official_credential": "MD PA"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology",
"state": "FL",
"license": "ME38730",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "0667336",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "30425",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "070000215",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brandon, FL
- Bay Area Home Health Care Inc
- Bay Area Pulmonary Associates, P.a.
- Bay Area Solutions for Independence
- Bay Area Speech-Language and Cognitive Therapy LLC
- Bay Area Surgicenter, LLC
- Bayada Home Health Care, Inc.
- Bayside Healthcare Brandon Inc
- Bayside Healthcare Brandon, Inc
- BDL National Inc
- Bea Hilbrands LMHC, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.