Montgomery Dermatology, P.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

MONTGOMERY DERMATOLOGY, P.C.

Practice address

4712 Berry Blvd
Montgomery, AL 36106-3080

Phone

(334) 834-3094

NPI assigned

Apr 2, 2008

Last updated

Apr 21, 2021By 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. John Lee Anthony, MDNPI 1184790479

Title

President/Owner

Phone

(334) 834-3094

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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 4

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.

• John Lee Anthony, M.D.

  • Dermatology Physician
  • Montgomery, AL
  • NPI 1184790479
  Medicare reassignment Care Compare group Authorized official
• Ellen Shea Burch-Burkhalter, PA-C

  • Physician Assistant
  • Montgomery, AL
  • NPI 1154570760
  Medicare reassignment Care Compare group
• Helen McLemore

  • Physician Assistant
  • Montgomery, AL
  • NPI 1457897654
  Medicare reassignment Care Compare group
• Porcia Bradford Love, MD

  • Dermatology Physician
  • Montgomery, AL
  • NPI 1326195124
  NPD (past)

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1982877619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4712 BERRY BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063080",
            "telephone_number": "334-834-3094",
            "fax_number": "334-263-0598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4712 BERRY BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063080",
            "telephone_number": "334-834-3094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY DERMATOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2021-04-21",
        "certification_date": "2020-11-20",
        "status": "A",
        "authorized_official_last_name": "ANTHONY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "334-834-3094",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Montgomery County Health Dept Prev Health Ed
• Montgomery County Health Dept Pri Care
• Montgomery County Health Dept STD
• Montgomery County Health Dept VFC Immun
• Montgomery Dental Arts LLC
• Montgomery Div-Bureau of Clinical Labs
• Montgomery Drug Co Inc. (Adams Drugs South)
• Montgomery Drug Company Inc (Adams Drugs-Copperfield)
• Montgomery Drug Company Inc (Adams Drugs-East)
• Montgomery Drug Company Inc (Adams Street Drug)

• Dermatology Physician in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Dermatology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.