INTEGRATED DERMATOLOGY GROUP, LLC (NPI# 1164930517) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164930517 |
| Entity Type | Organization |
| Organization Name | INTEGRATED DERMATOLOGY GROUP, LLC |
| Practice Address |
2525 Highway 1 S Ste A Greenville MS 38701-8354 |
| Mailing Address |
4700 Exchange Ct Ste 110 Boca Raton FL 33431-4450 |
| Practice Telephone | 6623351103 |
| Practice Fax Number | 6623358746 |
| Enumeration Date | 2018-01-19 |
| Last Update Date | 2018-01-19 |
| Authorized Official Name | ADAM S. PLOTKIN (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 5613142000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265941082 | Integrated Dermatology Group, LLC | Dermatology | 280 Washington St Ste 212, Brighton, MA 02135-3511 | 2017-09-25 |
| 1902327950 | Integrated Dermatology Group, LLC | Dermatology | 6021 University Blvd Ste 390, Ellicott City, MD 21043-6087 | 2017-06-29 |
| Street Address |
2525 HIGHWAY 1 S STE A |
| City | GREENVILLE |
| State | MS |
| Zip Code | 38701-8354 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134393952 | Dr Joseph R Terracina, Md, Pa | Dermatology | 2525 Highway 1 S Ste A, Greenville, MS 38701-8354 | 2008-04-14 |
| 1013522788 | Chasity Ann Sheppeard | Nurse Practitioner | 2525 Highway 1 S Ste A, Greenville, MS 38701-8354 | 2020-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851882328 | G & M Transportation LLC | Non-emergency Medical Transport (VAN) | 1525 South Dr. Mlk Dr, Suite E, Greenville, MS 38701 | 2018-05-21 |
| 1528564143 | Gyton Brijjetta Williams | Nurse Practitioner | 1400 East Union Street, Greenville, MS 38701 | 2018-04-03 |
| 1225552557 | Stephanie Epley | Counselor | 365 West Reed Rd Ste A-1, Greenville, MS 38701 | 2017-07-28 |
| 1861943425 | Roderick Montgomery | Non-emergency Medical Transport (VAN) | 537 Patricia Dr, Greenville, MS 38701 | 2016-10-19 |
| 1649694183 | Denise Wright | Nurse Practitioner | 1746-c Ms State Hwy 1 South, Greenville, MS 38701 | 2014-02-04 |
| 1174953525 | Sharkey-issaquena Adult Daycare | Psychologist | 449 Oakland Drive, Greenville, MS 38701 | 2013-11-21 |
| 1881953198 | New Hope Prosthetics & Orthodics Inc | Prosthetic/Orthotic Supplier | 585 Tennessee Gas Rd, Greenville, MS 38701 | 2012-05-07 |
| 1306139928 | Delta Regional Medical Center | Psychiatric Hospital | 300 South Washington Ave., Greenville, MS 38701 | 2011-05-17 |
| 1730305871 | First Choice Home Medical Equipment Inc. | Durable Medical Equipment & Medical Supplies | 428 Highway 82 East, Greenville, MS 38701 | 2007-04-17 |
| 1750435301 | Greg Heath Hairston | Chiropractor | 871 Hwy 1 South, Greenville, MS 38701 | 2007-01-22 |
| Find all providers in zip 38701 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982138715 | Skin Solution To Massage | Dermatology | 1 Chick Springs Rd Ste 207a, Greenville, SC 29609-4976 | 2017-04-19 |
| 1134393952 | Dr Joseph R Terracina, Md, Pa | Dermatology | 2525 Highway 1 S Ste A, Greenville, MS 38701-8354 | 2008-04-14 |
| 1427232131 | Eric J. Baker, M.d., P.a. | Dermatology | 26 Roper Corners Cir, Greenville, SC 29615-4833 | 2007-12-18 |
| 1760576383 | Eric J. Baker | Dermatology | 26 Roper Corners Circle, Greenville, SC 29615-4833 | 2006-10-03 |
| 1255388310 | Leslie Howard Poinsette | Dermatology | 28 Medical Ridge Dr, Greenville, SC 29605-4267 | 2006-05-27 |
| 1659323111 | Wayne Glenn Rogers | Dermatology | 3b Cleveland Ct, Greenville, SC 29607-2414 | 2006-05-16 |
| 1134171473 | Frances B Pardue | Dermatology | 7a Cleveland Ct, Greenville, SC 29607-2414 | 2006-05-16 |
| 1205814613 | John Thomas Kuhl | Dermatology | 920 Woodruff Rd, Greenville, SC 29607-4105 | 2006-01-05 |
| 1356330963 | Natures Partners | Dermatology | 8506 Wesley St, Greenville, TX 75402-3812 | 2005-10-17 |
| 1902891872 | Charles M Phillips | Dermatology | 517 Moye Blvd Fl 3, Ecu Physicians Dermatology, Greenville, NC 27834-2849 | 2005-09-15 |
| Find all providers in GREENVILLE | ||||
| City | GREENVILLE |
| Zip Code | 38701 |
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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.