Blue Ribbon Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

BLUE RIBBON DERMATOLOGY PLLC

Practice address

1150 N Watters Rd Ste 105
Allen, TX 75013-5536

Phone

(469) 331-3242

Fax

(469) 331-3243

NPI assigned

Dec 16, 2024

Last updated

Jul 3, 2025By 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. Nader Aboul-Fettouh, MDNPI 1508360298

Title

Physician

Phone

(469) 331-3242

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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 9

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.

• Nader Aboul-Fettouh, MD

  • MOHS-Micrographic Surgery Physician
  • Allen, TX
  • NPI 1508360298
  Medicare reassignment NPD Authorized official
• Amy Baum-Jones, PA

  • Physician Assistant
  • Prosper, TX
  • NPI 1679611032
  Medicare reassignment NPD
• Kristen Moriah Crawford, AUD

  • Audiologist
  • Grapevine, TX
  • NPI 1558985895
  NPD
• Mica Jill Ingram, AU.D.

  • Audiologist
  • Irving, TX
  • NPI 1720274061
  NPD
• Sabrina R Sipes, DPT

  • Physical Therapist
  • Allen, TX
  • NPI 1750626024

  Single Specialty

  NPD
• Bradley James Stewart

  • Audiologist
  • McKinney, TX
  • NPI 1245593607
  NPD
• Carly Nicole Thompson, DPT

  • Physical Therapist
  • Richardson, TX
  • NPI 1649730185
  NPD
• Sonal Vaidya, P.T.

  • Physical Therapist
  • Plano, TX
  • NPI 1083030720
  NPD
• Jessica Blair Williams

  • Audiologist
  • Dallas, TX
  • NPI 1871856237
  NPD

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751500800000",
    "number": "1962219535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N WATTERS RD STE 105",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750135536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N WATTERS RD STE 105",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750135536",
            "telephone_number": "469-331-3242",
            "fax_number": "469-331-3243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIBBON DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-16",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A",
        "authorized_official_last_name": "ABOUL-FETTOUH",
        "authorized_official_first_name": "NADER",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "469-331-3242",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Blackwood Kelly, MS,CCC-SLP
• Nick Blanchard Jr., DPT
• Susan Elizabeth Blandino, PSY.D.
• Bledkob Home Health Agency Inc.
• Blue Horizon Therapy
• Lillian Winslow Blue
• BNS Legacy (BNS Home Healthcare)
• Erin Teresa Boidock, DPT
• Brianna Bolden
• Sonya Bolden, MSW LCSW

• Dermatology Physician in Allen, TX
• Providers in Allen, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2025; 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.