ADVANCED DERMATOLOGY OF WYOMING, INC (NPI# 1427408319) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427408319 |
| Entity Type | Organization |
| Organization Name | ADVANCED DERMATOLOGY OF WYOMING, INC |
| Practice Address |
62 South Redmond Street Jackson WY 83001-8664 |
| Mailing Address |
Po Box 7406 Jackson WY 83002-7406 |
| Practice Telephone | 3077345864 |
| Mailing Telephone | 3077345864 |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2016-10-06 |
| Authorized Official Name | LINDA CRANDALL (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 9704843050 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Street Address |
62 SOUTH REDMOND STREET |
| City | JACKSON |
| State | WY |
| Zip Code | 83001-8664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861006108 | Anne Kathleen Milburn | Physical Therapist | 3620 S Park Drive, Jackson, WY 83001 | 2020-09-03 |
| 1568009637 | Katherine Pringle Ford | Case Manager/Care Coordinator | 2065 E. Limber Pine Road, Jackson, WY 83001 | 2019-12-07 |
| 1043878408 | Cossette Burnham | Physical Therapist | Four Pines Physical Therapy, 1090 S Hwy 89, Jackson, WY 83001 | 2019-05-31 |
| 1982169371 | Cynthia Buck Huyffer | Social Worker | 755a Cache Creek Drive, Jackson, WY 83001 | 2019-02-10 |
| 1093281594 | Lara Cilo | Speech-Language Pathologist | 1300 W. Valley Springs Road, Jackson, WY 83001 | 2018-10-23 |
| 1740776202 | Teton Oral and Maxillofacial Surgery | Dentist | 1160 Alpine Ln Ste 1d, Jackson, WY 83001 | 2018-07-09 |
| 1437642055 | Anna Yanchek | Physical Therapist | 1090 Us- 89, Jackson Hole, WY 83001 | 2018-06-08 |
| 1891200762 | Tyler Ross Wright | Chiropractor | 1325 Us-89, Suite 108, Jackson, WY 83001 | 2017-12-13 |
| 1073027280 | Root To Rise Counseling and Consulting, Pllc | Social Worker | 2033 Dandelion Court, Jackson, WY 83001 | 2017-11-27 |
| 1962923912 | Piper Worthington | Social Worker | 1910 High School Rd, Jackson, WY 83001 | 2017-06-29 |
| Find all providers in zip 83001 | ||||
| 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 |
|---|---|---|---|---|
| 1871814095 | Elizabeth Anne Gordon Spratt | Dermatology | 3333 Spring Arbor Rd Ste 500, Jackson, MI 49203-8605 | 2010-06-22 |
| 1962644013 | Virginia Anne Koubek | Dermatology | 87 Murray Guard Dr Ste B, Jackson, TN 38305-3775 | 2009-04-02 |
| 1053532226 | Julie P Wyatt | Dermatology | 3000 Old Canton Rd Ste 430, Jackson, MS 39216 | 2007-05-02 |
| 1265653745 | Brittany Wilson Baker | Dermatology | 984 W Broadway, Suite 4, Jackson, WY 83001-0000 | 2007-05-01 |
| 1982705570 | Louis Julian Wise Jr. | Dermatology | 3000 Old Canton Road, Suite 430, Jackson, MS 39216 | 2006-09-26 |
| 1215940937 | Sterling Ruffin Craig | Dermatology | 2817 North Highland Avenue, Suite A, Jackson, TN 38305-1789 | 2006-08-14 |
| 1366459026 | Chemene Quinn | Dermatology | 501 Marshall St Ste 406, Dermatology Consultants, Pllc, Jackson, MS 39202-1650 | 2006-08-02 |
| 1609893296 | Kenneth R. Maloney | Dermatology | 294 Summar Drive, Jackson, TN 38301 | 2006-07-17 |
| 1720039423 | William P Teer | Dermatology | 1320 Union University Dr, Jackson, TN 38305-3780 | 2006-05-15 |
| 1447233754 | Jonathan Glenn Baker | Dermatology | 984 West Broadway, Suite 4, Jackson, WY 83001-0000 | 2005-11-22 |
| Find all providers in JACKSON | ||||
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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.