CAMDEN DERMATOLOGY & MOHS SURGERY LLC (NPI# 1215440011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215440011 |
| Entity Type | Organization |
| Organization Name | CAMDEN DERMATOLOGY & MOHS SURGERY LLC |
| Practice Address |
195 Union St Rockport ME 04856-6107 |
| Mailing Address |
15 High St Camden ME 04843-1737 |
| Practice Telephone | 2077065030 |
| Practice Fax Number | 2077065030 |
| Mailing Telephone | 2077306323 |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2017-11-16 |
| Authorized Official Name | KERRY A LAVIGNE (OWNER) |
| Authorized Official Telephone | 2077306323 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
195 UNION ST |
| City | ROCKPORT |
| State | ME |
| Zip Code | 04856-6107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265549869 | Mckim C Peterson | Family Medicine | 195 Union St, Midcoast Medicine, Pa, Rockport, ME 04856-6107 | 2006-08-23 |
| 1205436011 | Jessica Emily Hennen | Physician Assistant | 195 Union St, Rockport, ME 04856-6107 | 2020-10-30 |
| 1598157869 | Jenny Lee Barrett-hibl | Nurse Practitioner | 195 Union St, Rockport, ME 04856-6107 | 2015-02-24 |
| 1891034559 | Charles Samuel Cohen | Physician Assistant | 195 Union St, Rockport, ME 04856-6107 | 2013-01-31 |
| 1821233230 | Doreen M Kendall | Neuromusculoskeletal Medicine & OMM | 195 Union St, Midcoast Medicine, Pa, Rockport, ME 04856-6107 | 2008-12-15 |
| 1184774184 | David Schmidt | Psychiatry & Neurology | 195 Union St, Rockport, ME 04856-6107 | 2007-01-11 |
| 1184736258 | Alison Scheib | Physician Assistant | 195 Union St, Rockport, ME 04856 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881171585 | Lisa Manley | Physical Therapist | 6 Glen Cove Drive, Pbmc, Rockport, Me, ME 04856 | 2018-07-25 |
| 1871096834 | Brenda K Berry | Registered Nurse | 731 Commercial Street, Rockport, ME 04856 | 2018-03-15 |
| 1174908495 | Atlantic Behavior Services, Inc | Behavioral Analyst | 112 Union Street, Rockport, ME 04856 | 2015-07-28 |
| 1326451212 | Abigail Bernett Ryan | Clinical Neuropsychologist | 220 Union St, Rockport, ME 04856 | 2014-06-09 |
| 1790024438 | Michelle Gallant | Dental Hygienist | 37 Chickawaukie Pond Rd, Rockport, ME 04856 | 2013-01-31 |
| 1316221666 | Nancy K Alexander | Advanced Practice Midwife | 3 Glen Cove Dr Ste 1, Rockport, ME 04856 | 2011-10-05 |
| 1619283793 | Karen Canfield | Social Worker | 41 Forsest St, Rockport, ME 04856 | 2010-08-26 |
| 1518283530 | Kendra Emery | Family Medicine | 7 Madelyn Ln Ste 200, Rockport, ME 04856 | 2010-04-15 |
| 1598999369 | Patricia L. Kristiansen | Occupational Therapy Assistant | 6 Madelyn Lane, Rockport, ME 04856 | 2009-05-08 |
| 1801020797 | Tiffany Ann Darge | Dental Hygienist | 1060 Commercial St., Rockport, ME 04856 | 2009-05-07 |
| Find all providers in zip 04856 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700052792 | Kerry Allison Lavigne | Dermatology | 6 Glen Cove Dr, Rockport, ME 04856-4240 | 2008-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952747784 | Dan Filitis | Dermatology | 6 E Chestnut St Ste 340, Augusta, ME 04330-5760 | 2013-05-20 |
| 1285656413 | Brian Patrick O'donnell | Dermatology | 407 Us Route 1, Freeport, ME 04032-7023 | 2006-07-24 |
Please comment or provide details below to improve the information on CAMDEN DERMATOLOGY & MOHS SURGERY LLC.
| 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.