Encore Dermatology, Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

ENCORE DERMATOLOGY, INC

Practice address

4900 Gettysburg Rd
Columbus, OH 43220-2520

Phone

(614) 442-0100

NPI assigned

Mar 8, 2010

Last updated

Jun 6, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gwyn R Londeree, M.D.NPI 1225025067

Title

Owner

Phone

(614) 442-1012

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 5

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.

• Gwyn Rene Londeree, M.D.

  • Specialist
  • Columbus, OH
  • NPI 1225025067
  Medicare reassignment Care Compare group NPD Authorized official
• Kristin L Abbruzzi, PA

  • Physician Assistant
  • Columbus, OH
  • NPI 1548228018
  Medicare reassignment Care Compare group
• Jade Hilliard

  • Physician Assistant
  • Columbus, OH
  • NPI 1407513369
  Medicare reassignment Care Compare group
• Michelle Concette Chambers, M.D.

  • Dermatology Physician
  • Columbus, OH
  • NPI 1538152954
  NPD (past)
• Monique Elise Kademian, MD

  • Dermatology Physician
  • Columbus, OH
  • NPI 1477767846
  NPD (past)

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

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717632000000",
    "number": "1912220799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 GETTYSBURG RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202520",
            "telephone_number": "614-442-1012",
            "fax_number": "614-442-7726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 GETTYSBURG RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432202520",
            "telephone_number": "614-442-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENCORE DERMATOLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-08",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "LONDEREE",
        "authorized_official_first_name": "GWYN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-442-1012",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.