FOREFRONT DERMATOLOGY, S.C. (NPI# 1255782306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255782306 |
| Entity Type | Organization |
| Organization Name | FOREFRONT DERMATOLOGY, S.C. |
| Practice Address |
2130 W Sycamore St Ste 200 Kokomo IN 46901 |
| Mailing Address |
801 York St Manitowoc WI 54220-4630 |
| Practice Telephone | 7654574455 |
| Practice Fax Number | 7654570056 |
| Mailing Telephone | 9206639016 |
| Mailing Fax Number | 9206841435 |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2018-05-21 |
| Authorized Official Name | DR. BETSY J WERNLI (PRESIDENT) |
| Authorized Official Telephone | 9204820671 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154815546 | Forefront Dermatology, S.c. | Dermatology | 7720 Us Highway 98 W Ste 240, Miramar Beach, FL 32550-7232 | 2018-06-19 |
| 1518480136 | Forefront Dermatology, S.c. | Dermatology | 8134 Old Georgetown Rd, Bethesda, MD 20814 | 2017-07-25 |
| 1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
| 1851822548 | Forefront Dermatology, S.c. | Dermatology | 1600 S Beacon Blvd, Suite 160, Grand Haven, MI 49417 | 2017-03-23 |
| 1245777994 | Forefront Dermatology, S.c. | Dermatology | 11137 U.S. 52, Brookville, IN 47012 | 2017-01-19 |
| 1982140265 | Forefront Dermatology, S.c. | Dermatology | 8567 Watson Rd, Webster Groves, MO 63119 | 2017-01-11 |
| 1386194371 | Forefront Dermatology, S.c. | Dermatology | 7200 Washington Ave, Suite 100, Mount Pleasant, WI 53406 | 2016-10-13 |
| 1356891402 | Forefront Dermatology, S.c. | Dermatology | 1515 S Green Bay Rd, Racine, WI 53406 | 2016-10-12 |
| 1619424744 | Forefront Dermatology, S.c. | Dermatology | 5700 Mexico Rd, Suite 14, Saint Peters, MO 63376 | 2016-09-07 |
| 1629524913 | Forefront Dermatology, S.c. | Dermatology | 159 S. English Station Road, Louisville, KY 40245 | 2016-08-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | FOREFRONT DERMATOLOGY, S.C., | 801 York St, Manitowoc, WI 54220 |
| Street Address |
2130 W SYCAMORE ST STE 200 |
| City | KOKOMO |
| State | IN |
| Zip Code | 46901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518451814 | Michelle Durm | Physician Assistant | 2130 W Sycamore St Ste 200, Kokomo, IN 46901-6461 | 2018-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607597 | Momentum Kokomo, LLC | Substance Abuse Rehabilitation Facility | 1236 N. Wabash Ave, Kokomo, IN 46901 | 2020-10-23 |
| 1457826869 | Jodi Gayle Lake | Developmental Therapist | 2523 Lorentson Ct, Kokomo, IN 46901 | 2018-10-11 |
| 1871088369 | Hope Behavioral Servies, LLC | Behavioral Analyst | 924 Clark St, Kokomo, IN 46901 | 2018-06-27 |
| 1164860706 | Renee Michelle Brown | Registered Nurse | 2776 Amberwood Place, Kokomo, IN 46901 | 2013-06-05 |
| 1063642916 | Michelle K Rush | Speech-Language Pathologist | 2532 Lauren Ln, Kokomo, IN 46901 | 2009-07-24 |
| 1396957189 | Lifetime Dental Care of In, PC | Dentist | 927 S Washington St, Kokomo, IN 46901 | 2007-05-04 |
| 1245458355 | Wagoner Medical Center, LLC | Internal Medicine | 2016 W Sycamore, Kokomo, IN 46901 | 2007-04-23 |
| 1053442723 | Jesusa Salhieh | Contractor | Genesis Rehab Bloom, Kokomo, IN 46901 | 2007-03-07 |
| 1740382928 | Donald A Fantuzzo Dds PC | Dentist | 2196 W Sycamore St, Kokomo, IN 46901 | 2006-09-01 |
| 1730125402 | Lawrence O Larson | Anesthesiology | 1907 W Sycamore, Kokomo, IN 46901 | 2006-06-21 |
| Find all providers in zip 46901 | ||||
| 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 |
|---|---|---|---|---|
| 1033130174 | Alexander Albert Fondak | Dermatology | 804 S Berkley Rd, Kokomo, IN 46901-5198 | 2006-07-22 |
| 1720477482 | Forefront Dermatology, S.c. | Dermatology | 804 S Berkley Rd, Kokomo, IN 46901 | 2015-01-20 |
| 1528333432 | Suburban Dermatology LLC | Dermatology | 1542 S Dixon Rd, Kokomo, IN 46902-7318 | 2012-03-12 |
| 1952592156 | Josephine Nkechi Okwechime | Dermatology | 1542 S Dixon Rd, Kokomo, IN 46902-7318 | 2007-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457998692 | Medovate, LLC | Dermatology | 9305 Calumet Ave Ste A1, Munster, IN 46321-2888 | 2019-12-06 |
| 1386107829 | Strausburg Dermatology Group LLC | Dermatology | 92 S Park Blvd, Greenwood, IN 46143-8836 | 2019-04-11 |
| 1467834127 | Emily W Shelley | Dermatology | 8433 Harcourt Rd Ste 310, Indianapolis, IN 46260-2198 | 2015-06-18 |
| 1396133518 | Forefront Dermatology, S.c. | Dermatology | 188 State Road 129 S. Ste B, Batesville Medical Arts Bldg, Batesville, IN 47006 | 2014-12-23 |
| 1003211392 | Forefront Dermatology, S.c. | Dermatology | 1473 N Gardner St Ste A, C/o Scott Memorial Hospital, Scottsburg, IN 47170 | 2014-10-29 |
| 1639580152 | Nikolajs Perdue | Dermatology | 6820 Parkdale Pl Ste 211, Indianapolis, IN 46254-6600 | 2014-05-19 |
| 1356785778 | Larry Gene Bond | Dermatology | 9637 W. County Rd 200 N., Frankfort, IN 46041 | 2013-04-29 |
| 1093057911 | Matthew Bradley Strausburg | Dermatology | 9292 N Meridian St Ste 210, Indianapolis, IN 46260-1828 | 2013-03-18 |
| 1730430513 | Robert Marshall Weiss | Dermatology | 6017 Benchmark-one, Floyds Knobs, IN 47119-9410 | 2012-09-20 |
| 1346597655 | Franciscan Medical Specialists | Dermatology | 757-45th Street, Ste 201, Munster, IN 46321 | 2012-08-07 |
| Find all providers with the same taxonomy | ||||
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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.