Active NPI
Integrated Dermatology of Bluefield, PLLC
- Dermatology Physician
- Bluefield, VA
National Provider Identifier
1902474422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Legal business name
- INTEGRATED DERMATOLOGY OF BLUEFIELD, PLLC
- Practice address
- 725 S College Ave
Bluefield, VA 24605-1640 - Phone
- (276) 326-3376
- NPI assigned
- Jun 11, 2021
- Last updated
- Jun 11, 2021
- 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
- Jeffrey S Fromowitz, MD
- Title
- Authorized Group Official
- Phone
- (561) 314-2000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | Primary |
Addresses
Primary practice location
725 S College Ave
Bluefield, VA 24605-1640
Mailing address
4700 Exchange CT Ste 110
Boca Raton, FL 33431-4450
Phone (561) 314-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA, WV
Enrollment records 2
National Provider Directory
National Provider DirectoryLocations
150 Peppers Ferry Rd
Wytheville, VA 24382
Phone (276) 228-2022
296 New Hope Rd
Princeton, WV 24740
Phone (304) 431-1101
296 New Hope Rd
Ste 1
Princeton, WV 24740
Phone (304) 425-9448
Practitioners & affiliated clinicians
Practitioners 13
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.
-
- Dermatology Physician
- Bluefield, VA
- NPI 1336760677
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623369600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1623369600000",
"number": "1902474422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 EXCHANGE CT STE 110",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334314450",
"telephone_number": "561-314-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 S COLLEGE AVE",
"city": "BLUEFIELD",
"state": "VA",
"postal_code": "246051640",
"telephone_number": "276-326-3376"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INTEGRATED DERMATOLOGY OF BLUEFIELD, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-06-11",
"last_updated": "2021-06-11",
"certification_date": "2021-06-11",
"status": "A",
"authorized_official_last_name": "FROMOWITZ",
"authorized_official_first_name": "JEFFREY",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "AUTHORIZED GROUP OFFICIAL",
"authorized_official_telephone_number": "561-314-2000",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bluefield, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.