Musick Dermatology & Advanced Clinical Spa, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036089938 Issued in IL

Legal business name

MUSICK DERMATOLOGY & ADVANCED CLINICAL SPA, LLC

Practice address

4948 Benchmark Centre Dr
Swansea, IL 62226-2027

Phone

(618) 628-2588

Fax

(618) 628-1363

NPI assigned

Jun 25, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Doris Ann Glauber

Title

Office Manager

Phone

(618) 628-2588

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/GRzkF6yCy_Pe-6F3SJzcXkCEiy_u6zZe/

Practitioners 7

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

• Laura E. McKinzie, NP

  • Nurse Practitioner
  • Maryville, IL
  • NPI 1922348002
  Medicare reassignment Care Compare group NPD
• Steve Earl Musick I, M.D.

  • Dermatology Physician
  • Swansea, IL
  • NPI 1831176775
  Medicare reassignment Care Compare group NPD
• Angela Elizabeth Nauman-Musick, APRN,CNP

  • Nurse Practitioner
  • Swansea, IL
  • NPI 1477530327
  Medicare reassignment Care Compare group NPD
• Gillian Joell Russell

  • Nurse Practitioner
  • Swansea, IL
  • NPI 1417744798
  Medicare reassignment Care Compare group NPD
• Lisa A. Boget, PA-C

  • Medical Physician Assistant
  • Swansea, IL
  • NPI 1619083102
  Medicare reassignment Care Compare group
• Elizabeth C. Ridley, PA

  • Physician Assistant
  • Swansea, IL
  • NPI 1801036629
  Medicare reassignment Care Compare group
• Rachelle A. Bandino, PA-C

  • Physician Assistant
  • San Antonio, TX
  • NPI 1619621745

  IL

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595376000000",
    "number": "1922260587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4948 BENCHMARK CENTRE DR",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262027",
            "telephone_number": "618-628-2588",
            "fax_number": "618-628-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4948 BENCHMARK CENTRE DR",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622262027",
            "telephone_number": "618-628-2588",
            "fax_number": "618-628-1363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSICK DERMATOLOGY & ADVANCED CLINICAL SPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-25",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A",
        "authorized_official_last_name": "GLAUBER",
        "authorized_official_first_name": "DORIS",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "618-628-2588",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036089938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa M. Moore-Schmitt, M.A., CCC-A
• Cheri B. Moore, LSW
• Andria Moran, CCC-SLP
• Sarah Patricia Mueller, LCPC
• George Michael Murphy, O.D.
• Steve Earl Musick I, M.D.
• My Joy Therapy LLC
• Nadiah LLC
• Teresa Marie Nadolski, PHARMD
• Angela Elizabeth Nauman-Musick, APRN,CNP

• Dermatology Physician in Swansea, IL
• Providers in Swansea, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.