Premier Dermatology of Florida LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

PREMIER DERMATOLOGY OF FLORIDA LLC

Practice address

109 Whitehall Dr Unit 117
St Augustine, FL 32086-5266

Phone

(904) 460-2388

Fax

(904) 460-2689

NPI assigned

Feb 2, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Joanna Lee McGetrick, MDNPI 1184940777

Title

Owner

Phone

(863) 258-0601

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BJADBD

Practitioners 1

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.

• Joanna L McGetrick, M.D.

  • Dermatology Physician
  • St Augustine, FL
  • NPI 1184940777
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706572800000",
    "number": "1952800112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 WHITEHALL DR UNIT 117",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865266",
            "telephone_number": "904-460-2388",
            "fax_number": "904-460-2689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 WHITEHALL DR UNIT 117",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865266",
            "telephone_number": "904-460-2388",
            "fax_number": "904-460-2689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DERMATOLOGY OF FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-02",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A",
        "authorized_official_last_name": "MCGETRICK",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-258-0601",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annie Christina Prchal, M.S. BCBA
• Precision Imaging St. Augustine, LLC
• Christopher Pregony, DPT
• Premier Allergist of Florida LLC (Allervie Health)
• Premier Chiropractic & Wellness St. Augustine, LLC
• Premier Steps Healthcare LLC
• Premiere Pilates Rehabilitation and Fitness
• Harry R Prevatt, PA
• Jennifer Price
• Samantha Price

• Dermatology Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.

Verify at the official NPI Registry.