FOREFRONT DERMATOLOGY, S.C. (NPI# 1487969507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487969507 |
| Entity Type | Organization |
| Organization Name | FOREFRONT DERMATOLOGY, S.C. |
| Practice Address |
801 York St Manitowoc WI 54220 |
| Mailing Address |
801 York St Manitowoc WI 54220-4630 |
| Practice Telephone | 9206835278 |
| Practice Fax Number | 9206869674 |
| Mailing Telephone | 9206835278 |
| Mailing Fax Number | 9206869674 |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2019-03-21 |
| 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 | 207NI0002X |
Dermatology Specialization: Clinical & Laboratory Dermatological Immunology |
Allopathic & Osteopathic Physicians | ||
| N | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
Allopathic & Osteopathic Physicians | ||
| Y | 207ND0900X |
Dermatology Specialization: Dermatopathology |
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 |
801 YORK ST |
| City | MANITOWOC |
| State | WI |
| Zip Code | 54220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932101060 | Kyung Ai Mireille Chae | Dermatology | 801 York St, Manitowoc, WI 54220-4630 | 2005-06-01 |
| 1578726717 | Kelli Ann Hutchens | Dermatology | 801 York St, Manitowoc, WI 54220-4630 | 2008-07-08 |
| 1053502005 | Sapna Patel Vaghani | Dermatology | 801 York St, Manitowoc, WI 54220-4630 | 2007-08-06 |
| 1457554917 | Willmar Davison Patino Cadavid | Dermatology | 801 York St, Manitowoc, WI 54220-4630 | 2007-06-11 |
| 1972669083 | David Earl Hammond | Dermatology | 801 York St, Manitowoc, WI 54220-4630 | 2007-01-01 |
| 1932209129 | Ling Xia | Dermatology | 801 York St, Manitowoc, WI 54220-4630 | 2006-09-25 |
| 1912944752 | Song Qing Zhao | Pathology | 801 York St, Manitowoc, WI 54220 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235614843 | Katherine Borchardt | Registered Nurse | 3520 Foxfire Ct, Manitowoc, WI 54220 | 2018-09-28 |
| 1285128215 | Aurora Pharmacy Inc | Pharmacy | 3509 Dewey Street, Suite 100, Manitowoc, WI 54220 | 2018-06-22 |
| 1477937274 | Baycare Clinic LLP | Psychiatry & Neurology | 4801 Expo Drive, Manitowoc, WI 54220 | 2015-07-13 |
| 1831593821 | Brittany Camille Schultz | Acupuncturist | 2510 Washington Street, Manitowoc, WI 54220 | 2014-10-20 |
| 1710311261 | Brian E Weitz | Physical Therapy Assistant | 960 S. Rapids Rd., Manitowoc, WI 54220 | 2013-09-01 |
| 1134499080 | Total Renal Care Inc | Clinic/Center | 3303 Dewey St, Manitowoc, WI 54220 | 2012-01-10 |
| 1679858534 | Lisa M Noworatzky | Marriage & Family Therapist | 926 S. 8th St., Manitowoc, WI 54220 | 2011-10-11 |
| 1306177225 | Cynthia Fay Wenzel | Licensed Practical Nurse | 915 East Linden Avenue, Manitowoc, WI 54220 | 2010-01-15 |
| 1851550628 | Roundys Supermarkets Inc | Pharmacy | 3300 Calumet Ave, Manitowoc, WI 54220 | 2008-06-05 |
| 1851566079 | Jennifer C Mcwilliams | Registered Nurse | 1004 Nth 8th St., Manitowoc, WI 54220 | 2008-04-29 |
| Find all providers in zip 54220 | ||||
| Taxonomy Code | 207ND0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Dermatopathology |
| A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/; American Osteopathic Board of Dermatology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Dermatology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376526095 | Eric Morgan Hanson | Dermatology | 1515 Randolph Ct, Manitowoc, WI 54220-8345 | 2005-11-28 |
| 1578726717 | Kelli Ann Hutchens | Dermatology | 801 York St, Manitowoc, WI 54220-4630 | 2008-07-08 |
| 1457554917 | Willmar Davison Patino Cadavid | Dermatology | 801 York St, Manitowoc, WI 54220-4630 | 2007-06-11 |
| 1932209129 | Ling Xia | Dermatology | 801 York St, Manitowoc, WI 54220-4630 | 2006-09-25 |
| 1578515904 | Forefront Dermatology, S.c. | Dermatology | 1515 Randolph Ct, Manitowoc, WI 54220 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366776601 | Fleming Dermatopathology, LLC | Dermatology | 1661 N Water St, #500, Milwaukee, WI 53202-2085 | 2009-09-18 |
| 1073555033 | Fox Cities Dermatology & Skin Cancer Center, Sc | Dermatology | 188 Rockwood Ln, Neenah, WI 54956 | 2006-06-12 |
| 1730140245 | Andreas Friedl | Dermatology | 600 Highland Ave, Madison, WI 53792 | 2006-04-01 |
| 1821059346 | Wei Huang | Dermatology | 600 Highland Ave, Madison, WI 53792 | 2006-04-01 |
| 1609835669 | B Jack Longley | Dermatology | 451 Junction Rd, Madison, WI 53717 | 2006-03-20 |
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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.