SKIN CANCER & COSMETIC DERMATOLOGY CENTER, PC (NPI# 1144419458) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144419458 |
| Entity Type | Organization |
| Organization Name | SKIN CANCER & COSMETIC DERMATOLOGY CENTER, PC |
| Practice Address |
2253 Chambliss Ave Nw Suite 202 Cleveland TN 37311-3861 |
| Mailing Address |
1107 Memorial Dr Suite 201 Dalton GA 30720-8662 |
| Practice Telephone | 4234723332 |
| Mailing Telephone | 7062777311 |
| Mailing Fax Number | 7062723512 |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2010-11-23 |
| Authorized Official Name | MRS. KELLEY FINNELL (PRACTICE MANAGER) |
| Authorized Official Telephone | 7062777311 |
| Is Organization Subpart | Y |
| Parent Organization Name | SKIN CANCER & COSMETIC DERMATOLOGY CENTER, PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376605394 | Skin Cancer & Cosmetic Dermatology Center, PC | Specialist | 1107 Memorial Drive, Suite 201, Dalton, GA 30720 | 2006-12-15 |
| Street Address |
2253 CHAMBLISS AVE NW SUITE 202 |
| City | CLEVELAND |
| State | TN |
| Zip Code | 37311-3861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316988595 | William Frank Johnson II | Surgery | 2253 Chambliss Ave Nw, Suite 100, Cleveland, TN 37311-3861 | 2006-06-09 |
| 1497065494 | East Tennessee Oral & Maxillofacial Surgery, PC | Dentist | 2253 Chambliss Ave Nw, Suite 403, Cleveland, TN 37311-3861 | 2010-10-12 |
| 1033436837 | Asma N Khatri | Internal Medicine | 2253 Chambliss Ave Nw, Ste 400, Cleveland, TN 37311-3861 | 2010-05-03 |
| 1578798666 | William Russell May Jr. | Dentist | 2253 Chambliss Ave Nw, Suite 403, Cleveland, TN 37311-3861 | 2009-05-19 |
| 1013153857 | Margie Amanda Cook | Nurse Practitioner | 2253 Chambliss Ave Nw, Suite 202, Cleveland, TN 37311 | 2008-12-29 |
| 1982780060 | James Kent Hulvey | Nurse Practitioner | 2253 Chambliss Ave Nw, Suite 200, Cleveland, TN 37311-3861 | 2006-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114433570 | Kirstee Williams | Counselor | 1120 North Ocoee Street, Lee University, Cleveland, TN 37311 | 2017-12-21 |
| 1285070458 | Scott Daniel Pugh | Counselor | 183 1st St Ne, Cleveland, TN 37311 | 2013-05-15 |
| 1407299191 | Bess E Howard | Nurse Practitioner | 2449 Spring Creek Blvd, Ne, Cleveland, TN 37311 | 2013-04-11 |
| 1588913925 | Thomas C Reese | Hearing Instrument Specialist | 60 25th Street Ne, Suite 5, Cleveland, TN 37311 | 2012-08-30 |
| 1932484607 | Southeast Tn Human Resource Agency | Non-emergency Medical Transport (VAN) | 165 Edwards Street Se, Cleveland, TN 37311 | 2011-10-13 |
| 1588956106 | Lee M Radford | Orthopaedic Surgery | 2350 N Ocoee Street, Cleveland, TN 37311 | 2011-05-16 |
| 1124251913 | Mcfarland Group Inc. | Durable Medical Equipment & Medical Supplies | 1300 25th St Nw # 104, Cleveland, TN 37311 | 2009-08-27 |
| 1952554834 | Bradley Cleveland Services Inc | Counselor | 2611 Bower Lane, Cleveland, TN 37311 | 2008-10-23 |
| 1851543151 | Bradley Cleveland Services, Inc | Counselor | 2601 Bower Lane Se, Cleveland, TN 37311 | 2008-10-17 |
| 1306098082 | Kidney Center of Cleveland, LLC | Clinic/Center | 2253 Chambliss Avenue, Cleveland, TN 37311 | 2008-10-14 |
| Find all providers in zip 37311 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265896872 | Lindsay Brewster | Specialist | 163 County Road 2298, Cleveland, TX 77327-0118 | 2016-04-09 |
| 1972974855 | Ronald Sherman Coleman | Specialist | 343 Leatha Ln Nw, Cleveland, TN 37312-6444 | 2015-10-17 |
| 1457740961 | Carol Reaves | Specialist | 1113 East 141, St., Cleveland, OH 44110-3685 | 2015-01-21 |
| 1891118378 | Todd Karp | Specialist | 21855 Eaton Rd, Cleveland, OH 44126-2311 | 2014-02-04 |
| 1619226180 | Thomas M Lott Sr. | Specialist | 2486 Adair Mill Rd, Cleveland, GA 30528-3322 | 2012-08-30 |
| 1760712517 | Patrick Alton Gladding | Specialist | 2409 Lee Rd, Cleveland Heights, Cleveland, OH 44118-4124 | 2009-12-29 |
| 1477795227 | Linda Dorsey | Specialist | 2538 Keith St Nw Ste 8, Cleveland, TN 37312-3738 | 2009-03-25 |
| 1598906117 | John Robert Fowler Jr. | Specialist | Emergency Services Institute E 19, 9500 Euclid Avenue, Cleveland, OH 44195-0001 | 2009-03-11 |
| 1275772931 | Raed Nabil Bou Matar | Specialist | 2801 Mlk Jr Dr, Cleveland, OH 44104-3815 | 2009-02-19 |
| 1447405444 | Ivy Trinell Chambers | Specialist | 3737 E 154th St, Cleveland, OH 44120-4917 | 2008-11-18 |
| Find all providers in CLEVELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.