EM DIMITRI DO PMC (NPI# 1285993337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285993337 |
| Entity Type | Organization |
| Organization Name | EM DIMITRI DO PMC |
| Other Organization Name | DIMITRI DERMATOLOGY |
| Practice Address |
624 Highway 90 Bay St Louis MS 39520-2715 |
| Mailing Address |
300 Gateway Dr Slidell LA 70461-5540 |
| Practice Telephone | 2284675644 |
| Practice Fax Number | 2284679961 |
| Mailing Telephone | 9856434512 |
| Mailing Fax Number | 9856434513 |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2012-05-10 |
| Authorized Official Name | KAREN RACHEL DRAKE (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 9856434512 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 21866 | MS | Allopathic & Osteopathic Physicians |
| Y | 207N00000X | Dermatology | 14885R | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 07454201 | 05 |
| Other Name | Type Code |
|---|---|
| Dimitri Dermatology | Doing Business As Name - Organization |
| Street Address |
624 HIGHWAY 90 |
| City | BAY ST LOUIS |
| State | MS |
| Zip Code | 39520-2715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174799688 | Matthew Peter Brennan | General Practice | 624 Highway 90, Bay St Louis, MS 39520-2715 | 2008-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508470568 | Michael Stephens | Student in an Organized Health Care Education/Training Program | 236 Eighth Street, Bay Saint Louis, MS 39520 | 2020-09-06 |
| 1437400959 | Hancock Medical Health Services, Inc. | Nurse Practitioner | 600 Pine St., Bay St Louis, MS 39520 | 2012-09-24 |
| 1245581768 | Hancock Medical Health Services, Inc. | Nurse Practitioner | 602 Pine St., Bay St Louis, MS 39520 | 2012-09-24 |
| 1912258427 | Hancock Medical Health Services, Inc. | Nurse Practitioner | 6590 Lakeshore Road, Bay St Louis, MS 39520 | 2012-09-24 |
| 1942551445 | Hancock Medical Health Services | Nurse Practitioner | 750 Blue Meadow Road, Bay St Louis, MS 39520 | 2012-09-24 |
| 1134404809 | Hancock Chiropractic LLC | Chiropractor | 806 Hwy 90, Bay St. Louis, MS 39520 | 2011-10-13 |
| 1669762902 | Stacey Marie Kreher | Nurse Practitioner | 1009 Benigno Ln., Hancock Women's Center, Bay St. Louis, MS 39520 | 2011-04-07 |
| 1639352123 | Joyce Deloris Buie | Nurse Practitioner | 3062 Longfellow Rd, #25, Bay St. Louis, MS 39520 | 2007-12-07 |
| 1336346451 | Ochsner Medical Center - Hancock LLC | Clinic/Center | 3068 Port and Harbor Dr, Bay St Louis, MS 39520 | 2007-07-02 |
| 1043437684 | The Beach Surgical Group | Clinic/Center | 952 Green Meadow Rd., Bay St Louis, MS 39520 | 2007-04-18 |
| Find all providers in zip 39520 | ||||
| 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 |
|---|---|---|---|---|
| 1760043046 | Skin In The Game, Pllc | Dermatology | 6510 Highway 90, Gautier, MS 39553-5015 | 2019-06-26 |
| 1427535079 | Jenna Joe Rose Cooper | Dermatology | 2204 Jefferson Davis Dr, Oxford, MS 38655-5222 | 2018-07-26 |
| 1427460849 | Anna Allred Wile | Dermatology | 4331 Highway 39 N Ste A, Meridian, MS 39301-1007 | 2014-05-21 |
| 1134558331 | South Central Clinics, Inc | Dermatology | 920 Matthew Dr Ste 8, Waynesboro, MS 39367-2553 | 2013-11-07 |
| 1407296825 | Ashley Nicole Emerson | Dermatology | 6510 Highway 90 Ste C, Gautier, MS 39553-5015 | 2013-06-29 |
| 1265729719 | Jasmine C. Hollinger | Dermatology | 2080 S Frontage Rd Ste 113, Vicksburg, MS 39180-5882 | 2011-07-06 |
| 1295022861 | Kenneth Daniel Saul | Dermatology | 5002 Highway 39 N Bldg A, Meridian, MS 39301-1078 | 2011-07-05 |
| 1689969735 | Adam C Byrd | Dermatology | 313 N Court Ave, Ummc Dermatology - Louisville Clinic, Louisville, MS 39339 | 2011-06-16 |
| 1063724987 | Lyndsay R Shipp | Dermatology | 705 Sisk Ave Ste 105, Oxford, MS 38655-3413 | 2010-07-08 |
| 1144545195 | Lisa Renee Chastant | Dermatology | 81 Mdos/sgomd, 301 Fisher St., Keesler Afb, MS 39534-2519 | 2010-04-01 |
| Find all providers with the same taxonomy | ||||
| City | BAY ST LOUIS |
| Zip Code | 39520 |
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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.