ADVANCED DERMATOLOGY OF THE MIDLANDS PC (NPI# 1497182273) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497182273 |
| Entity Type | Organization |
| Organization Name | ADVANCED DERMATOLOGY OF THE MIDLANDS PC |
| Practice Address |
12910 Pierce St Ste 120 Omaha NE 68144-1106 |
| Mailing Address |
2213 Grand Ave Des Moines IA 50312-5305 |
| Practice Telephone | 4029333770 |
| Practice Fax Number | 4029333633 |
| Mailing Telephone | 5152373974 |
| Mailing Fax Number | 5158832692 |
| Enumeration Date | 2013-10-10 |
| Last Update Date | 2019-02-06 |
| Authorized Official Name | JAMES M. SHEHAN (PRESIDENT) |
| Authorized Official Telephone | 4029333770 |
| Authorized Official Credential | MD, FAAD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 1497182273 | 05 | |
| NE | 100263840-00 | 05 |
| Street Address |
12910 PIERCE ST STE 120 |
| City | OMAHA |
| State | NE |
| Zip Code | 68144-1106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316041734 | James M. Shehan | Dermatology | 12910 Pierce St Ste 120, Omaha, NE 68144-1106 | 2006-09-08 |
| 1841673738 | Rachel R. Person | Dermatology | 12910 Pierce St Ste 120, Omaha, NE 68144-1106 | 2015-07-09 |
| 1508291717 | Jacob James Ridder | Dermatology | 12910 Pierce St Ste 120, Omaha, NE 68144-1106 | 2013-09-06 |
| 1730453200 | Sara Stephenson | Dermatology | 12910 Pierce St Ste 120, Omaha, NE 68144-1106 | 2012-03-01 |
| 1851568703 | Mathew Alan Davey | Dermatology | 12910 Pierce St Ste 120, Omaha, NE 68144-1106 | 2008-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720627292 | Jessica Wissink | Physical Therapist | 2275 South 132nd St, Omaha, NE 68144 | 2020-01-02 |
| 1881165397 | Elle Klink | Chiropractor | 2527 S 140th Street, Omaha, NE 68144 | 2018-12-10 |
| 1336649987 | Colton A Palmer | Nurse Practitioner | 11725 Arbor St Ste 230, Omaha, NE 68144 | 2018-02-20 |
| 1780121335 | Deborah Palmer | Massage Therapist | 2429 South 120th, Omaha, NE 68144 | 2017-01-20 |
| 1750833851 | Amanda Mcgary Tatro | Counselor | 11929 Elm St Suite 12a, Omaha, NE 68144 | 2016-10-25 |
| 1770946105 | Kindis Ward | Counselor | 13435 A. Street, Omaha, NE 68144 | 2016-04-02 |
| 1649679937 | Brian Douglas Smith | Physical Therapist | 13934 Gold Circle, Omaha, NE 68144 | 2014-08-22 |
| 1346587334 | Elite Professionals Home Care LLC | Home Health | 13306 A Street, Omaha, NE 68144 | 2013-01-10 |
| 1821345471 | Angelia D Henderson | Skilled Nursing Facility | 2525 S. 135th Ave, Omaha, NE 68144 | 2012-08-13 |
| 1073872123 | Midwest Physical Therapy Services, PC | Physical Therapist | 11640 Arbor Street #200, Omaha, NE 68144 | 2012-05-10 |
| Find all providers in zip 68144 | ||||
| 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 |
|---|---|---|---|---|
| 1942628839 | Deirdre Anne Stolmeier | Dermatology | 515 N 162nd Ave Ste 302, Omaha, NE 68118 | 2014-03-28 |
| 1528217395 | Justin Gerhard Madson | Dermatology | 4242 Farnam St., Suite 360, Omaha, NE 68131-2850 | 2008-09-16 |
| 1457551889 | Dermatology Specialists of Omaha LLC | Dermatology | 909 N 96th St Ste 201, Omaha, NE 68114-2508 | 2007-07-24 |
| 1508064833 | Robert J. Fonda, M.d., P.C. | Dermatology | 8601 W. Dodge Rd., Suite 118, Omaha, NE 68114-3457 | 2007-07-09 |
| 1740494806 | Tricia L Hultgren | Dermatology | 909 N 96 St, Suite 201, Omaha, NE 68114-2508 | 2007-05-09 |
| 1053461137 | Center of Dermatology, PC | Dermatology | 10110 Nicholas Street, Suite #103, Omaha, NE 68114-2185 | 2007-01-11 |
| 1316041734 | James M. Shehan | Dermatology | 12910 Pierce St Ste 120, Omaha, NE 68144-1106 | 2006-09-08 |
| 1801906326 | Christopher J Huerter | Dermatology | 601 N 30th St Ste 5700, Omaha, NE 68131-2137 | 2006-08-30 |
| 1154435691 | Scott M Debates | Dermatology | 515 N 162nd Avennue, Ste. 302, Omaha, NE 68118 | 2006-08-19 |
| 1568436210 | Robert J. Fonda | Dermatology | 106 S 88th St, Omaha, NE 68114-4020 | 2006-02-16 |
| Find all providers in OMAHA | ||||
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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.