PAUL D. REICHERTER, MD, PC (NPI# 1407055437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407055437 |
| Entity Type | Organization |
| Organization Name | PAUL D. REICHERTER, MD, PC |
| Other Organization Name | ADVANCED SKIN CENTER |
| Practice Address |
1813 W Harvard Ave Ste 310 Roseburg OR 97471-2756 |
| Practice Telephone | 5416727546 |
| Practice Fax Number | 5419578446 |
| Mailing Telephone | 5416727546 |
| Mailing Fax Number | 5419578446 |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2016-02-15 |
| Authorized Official Name | PAUL D REICHERTER (PRESIDENT) |
| Authorized Official Telephone | 5416727546 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
MD23536 | OR | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
MD23536 | OR | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | MD23536 | OR | Allopathic & Osteopathic Physicians |
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
MD23536 | OR | Allopathic & Osteopathic Physicians |
| Y | 207NI0002X |
Dermatology Specialization: Clinical & Laboratory Dermatological Immunology |
MD23536 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 286785 | 05 | |
| OR | BCBS | 838392000 | 01 |
| MEDICARE RAILROAD | DC5977 | 01 | |
| OR | CLIA | 38D1028702 | 01 |
| OR | OHP | 286785 | 01 |
| Other Name | Type Code |
|---|---|
| Advanced Skin Center | Other Name - Individual/Organization |
| Street Address |
1813 W HARVARD AVE STE 310 |
| City | ROSEBURG |
| State | OR |
| Zip Code | 97471-2756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366428203 | Laura C Smith | Physician Assistant | 1813 W Harvard Ave Ste 310, Roseburg, OR 97470-2756 | 2005-12-22 |
| 1982054169 | Sarah Vouch | Physician Assistant | 1813 W Harvard Ave Ste 310, Roseburg, OR 97471-2756 | 2016-06-17 |
| 1437535077 | Winthrop T Head | Physician Assistant | 1813 W Harvard Ave Ste 310, Roseburg, OR 97471-2756 | 2015-08-05 |
| 1770986051 | Jody Michelle Zurita | Nurse Practitioner | 1813 W Harvard Ave Ste 310, Roseburg, OR 97471-2756 | 2014-10-01 |
| 1700858289 | Margot Ouimette | Physician Assistant | 1813 W Harvard Ave Ste 310, Roseburg, OR 97470-2756 | 2006-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841805660 | Rae Ann Barnes | Pharmacist | 913 Ne Garden Valley Blvd, Pharmacy, Roseburg, OR 97471 | 2020-09-09 |
| 1023651031 | Colton Phillips | Behavioral Analyst | 940 Nw Garden Valley Bvld #104, Roseburg, OR 97471 | 2019-10-22 |
| 1952884876 | Meredith Krugel Lcsw PC | Clinic/Center | 2225 Nw Stewart Parkway Ste 200, Roseburg, OR 97471 | 2018-09-07 |
| 1114456563 | Philip Kaser Family, LLC | Pharmacy | 1175 W. Harvard Avenue, Roseburg, OR 97471 | 2017-06-08 |
| 1053854208 | Icco LLC | Clinic/Center | 1740 Nw Goetz Street, Roseburg, OR 97471 | 2016-11-21 |
| 1770034589 | Evie Jepsen | Case Manager/Care Coordinator | 2700 Stewart Parkway Annex B, Suite 110, Roseburg, OR 97471 | 2016-10-17 |
| 1932551256 | Jonathan Schmidt | Licensed Practical Nurse | 913 Nm Garden Valley Blvd, Va Roseburg Medical Center, Roseburg, OR 97471 | 2016-07-11 |
| 1932580586 | Jeffrey Mark Wareham | Case Manager/Care Coordinator | 2700 Medical Loop, Annex B, Roseburg, OR 97471 | 2015-06-09 |
| 1558784215 | Ginger Jean Thibedeau | Massage Therapist | 3019 Nw Stewart Parkway, Suite 304 #183, Roseburg, OR 97471 | 2014-01-30 |
| 1427303122 | Karishma Parekh | Internal Medicine | 2460 Nw Stewart Pkwy Ste 103, Roseburg, OR 97471 | 2012-07-18 |
| Find all providers in zip 97471 | ||||
| Taxonomy Code | 207NI0002X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Clinical & Laboratory Dermatological Immunology |
| A dermatologist who utilizes various specialized laboratory procedures to diagnose disorders characterized by defective responses of the body's immune system. Immunodermatologists also may provide consultation in the management of these disorders and administer specialized forms of therapy for these diseases. |
| 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. |
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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.