Organization Active NPI

Midstate Skin Institute, LLC

  • Dermatology Physician
  • Ocala, FL
National Provider Identifier
1912258989
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME112254 Issued in FL
Legal business name
MIDSTATE SKIN INSTITUTE, LLC
Practice address
1740 SE 18TH St Ste 1102
Ocala, FL 34471-5447
Phone
(352) 512-0092
Fax
(352) 512-0093
NPI assigned
Sep 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Authorized official

Name
Ashley Cauthen, M.D.NPI 1720254071
Title
President/Managing Member
Phone
(352) 512-0092

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 ME112254 FL Primary

Addresses

Primary practice location

1740 SE 18TH St Ste 1102
Ocala, FL 34471-5447

Mailing address

1740 SE 18TH St Ste 1102
Ocala, FL 34471-5447
Phone (352) 512-0092

Other practice location 1

7648 SW 61st Ave., STE 100
Ocala, FL 34476-8310
Phone (352) 512-0092

Other practice location 2

3210 SW 33rd Rd Ste 101
Ocala, FL 34474-7409
Phone (352) 470-0770

Other practice location 3

7550 SW 61st Ave Ste 1
Ocala, FL 34476-8310
Phone (352) 732-7337

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130103000454 FL Part B Supplier - Clinic/Group Practice 3870746605 Receives reassigned benefits from 22 practitioners
Practice locations: Lutz, FL; Ocala, FL

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
10D2123689Midstate Skin Institute LLC3210 SW 33Rd Road Ste 101, Ocala, FL 34474ComplianceMar 14, 2027
10D2172515Midstate Skin Institute LLC7550 SW 61St Ave Ste 1, Ocala, FL 34476Certificate of waiverSep 23, 2027
10D2172520Midstate Skin Institute LLC1740 SE 18TH St Ste 1102, Ocala, FL 34471Certificate of waiverSep 23, 2027

National Provider Directory

National Provider Directory

Locations

1740 SE 18th St
Ste 1103
Ocala, FL 34471
Phone (352) 512-0092

7648 SW 61st Ave
Ocala, FL 34476

1740 SE 18th St
Ste 1102
Ocala, FL 34471
Phone (352) 412-0092

7648 SW 61st Ave
Ste 100
Ocala, FL 34476
Phone (352) 512-0092

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1348963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1912258989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 SE 18TH ST STE 1102",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344715447",
            "telephone_number": "352-512-0092",
            "fax_number": "352-512-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 SE 18TH ST STE 1102",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344715447",
            "telephone_number": "352-512-0092",
            "fax_number": "352-512-0093"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7648 SW 61st Ave., STE 100",
            "address_purpose": "LOCATION",
            "city": "Ocala",
            "state": "FL",
            "postal_code": "344768310",
            "country_code": "US",
            "telephone_number": "352-512-0092",
            "fax_number": "352-512-0093",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3210 SW 33rd Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Ocala",
            "state": "FL",
            "postal_code": "344747409",
            "country_code": "US",
            "telephone_number": "352-470-0770",
            "fax_number": "352-512-0093",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7550 SW 61st Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Ocala",
            "state": "FL",
            "postal_code": "344768310",
            "country_code": "US",
            "telephone_number": "352-732-7337",
            "fax_number": "352-512-0093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDSTATE SKIN INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-30",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-24",
        "status": "A",
        "authorized_official_last_name": "CAUTHEN",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "PRESIDENT/MANAGING MEMBER",
        "authorized_official_telephone_number": "352-512-0092",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME112254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.

Verify at the official NPI Registry.