Dermatology Associates PA

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

Legal business name

DERMATOLOGY ASSOCIATES PA

Practice address

4021 Balmoral Dr SW
Huntsville, AL 35801-6403

Phone

(256) 539-2741

Fax

(256) 539-2775

NPI assigned

Mar 23, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Martin Beck

Title

Administrator

Phone

(256) 539-2741

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Practitioners 5

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

• Lon F Raby Jr., MD

  • Dermatology Physician
  • Huntsville, AL
  • NPI 1508844937
  Medicare reassignment Care Compare group NPD
• John K Sowell, MD

  • Dermatology Physician
  • Huntsville, AL
  • NPI 1851376263
  Medicare reassignment Care Compare group NPD
• Patricia J Wilson, MD

  • Dermatology Physician
  • Huntsville, AL
  • NPI 1083692842
  Medicare reassignment Care Compare group NPD
• Kelly M Durham, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Huntsville, AL
  • NPI 1831148220
  Medicare reassignment Care Compare group
• Brittny White

  • Physician Assistant
  • Huntsville, AL
  • NPI 1043735335
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340841600000",
    "number": "1972562213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4021 BALMORAL DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016403",
            "telephone_number": "256-539-2741",
            "fax_number": "256-539-2775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 BALMORAL DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016403",
            "telephone_number": "256-539-2741",
            "fax_number": "256-539-2775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2012-06-28",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "256-539-2741",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "CC2318",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "520402120",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Department of Veteran Affairs
• Adam James Joseph Depew, LAT, ATC
• Christopher Depew
• Donald Joseph Derivaux, MD
• Rachel Derivaux, MSW
• John Webster Deshazo Sr., D.M.D.
• Patti Deshazo
• Muriel Aline Desimone, MD
• Desire Home Care Services
• Richard Paul Desruisseau, MD

• Procedural Dermatology Physician in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Procedural Dermatology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; 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.