Organization Active NPI

Dermatology Associates Inc. Apmc

  • Dermatology Physician
  • West Monroe, LA
National Provider Identifier
1891816286
Registry record updated Oct 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
024992 Issued in LA
Legal business name
DERMATOLOGY ASSOCIATES INC. APMC
Practice address
324 Circle Drive
West Monroe, LA 71291-5308
Phone
(318) 322-3535
NPI assigned
Apr 3, 2007
Last updated
Oct 25, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2010

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

Authorized official

Name
Virginia P Lewis, M.D.NPI 1528027620
Title
President
Phone
(318) 322-3535

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 024992 LA Primary

Addresses

Primary practice location

324 Circle Drive
West Monroe, LA 71291-5308

Mailing address

324 Circle Drive
West Monroe, LA 71291-5308
Phone (318) 322-3535

Other identifiers 1

IdentifierTypeStateIssuer
1423238MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040525000209 LA Part B Supplier - Clinic/Group Practice 6204817547 Receives reassigned benefits from 2 practitioners
Practice locations: West Monroe, LA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D1026660Dermatology Associates324 Circle Drive, West Monroe, LA 71291Provider-performed microscopyJun 9, 2028

National Provider Directory

National Provider Directory

Locations

324 Circle Dr
West Monroe, LA 71291
Phone (318) 322-3535

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287964800000",
    "number": "1891816286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 CIRCLE DRIVE",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915308",
            "telephone_number": "318-322-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 CIRCLE DRIVE",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915308",
            "telephone_number": "318-322-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES INC. APMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2010-10-25",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-322-3535",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "LA",
            "license": "024992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1423238",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.