Three Rivers Dermatology, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD453980 Issued in PA

Legal business name

THREE RIVERS DERMATOLOGY, LLC

Practice address

980 Beaver Grade Rd
Suite 10a
Coraopolis, PA 15108-2774

Phone

(412) 262-4911

Fax

(412) 262-7856

NPI assigned

Jul 15, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Damon McClain, M.D.NPI 1063747178

Title

Owner

Phone

(412) 262-4911

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Practitioners 5

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

• Damon M. McClain, M.D.

  • Dermatology Physician
  • Coraopolis, PA
  • NPI 1063747178
  Medicare reassignment Care Compare group NPD Authorized official
• Susannah Elizabeth Berke, MD

  • Dermatology Physician
  • Coraopolis, PA
  • NPI 1447468970
  Medicare reassignment Care Compare group NPD
• Molly Dale McIntyre, PA-C

  • Medical Physician Assistant
  • Coraopolis, PA
  • NPI 1942596457
  Medicare reassignment
• Leah Kelly Greco

  • Physician Assistant
  • Medina, OH
  • NPI 1215513478
  NPD
• Kristen Ann Stephen, MD

  • Dermatology Physician
  • Wexford, PA
  • NPI 1114968112
  NPD (past)

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436918400000",
    "number": "1962886424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 BEAVER GRADE RD",
            "address_2": "SUITE 10A",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "151082774",
            "telephone_number": "412-262-4911",
            "fax_number": "412-262-7856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 BEAVER GRADE RD",
            "address_2": "SUITE 10A",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "151082774",
            "telephone_number": "412-262-4911",
            "fax_number": "412-262-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-15",
        "last_updated": "2015-07-15",
        "status": "A",
        "authorized_official_last_name": "MCCLAIN",
        "authorized_official_first_name": "DAMON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "412-262-4911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "PA",
            "license": "MD453980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Coraopolis, PA
• Providers in Coraopolis, PA by specialty
• Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; 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.