CRESCENT CITY DERMATOLOGY, LLC (NPI# 1518100312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518100312 |
| Entity Type | Organization |
| Organization Name | CRESCENT CITY DERMATOLOGY, LLC |
| Practice Address |
120 Meadowcrest St Suite 460 Gretna LA 70056-5255 |
| Mailing Address |
1107 S Peters St Unit 404 New Orleans LA 70130-1759 |
| Practice Telephone | 6149370319 |
| Mailing Telephone | 6149370319 |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2009-04-15 |
| Authorized Official Name | DR. STEPHEN JOHN KLINGER (PART OWNER) |
| Authorized Official Telephone | 6149370319 |
| Authorized Official Credential | M.D., M.P.H. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 200999 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NPI NUMBER | 1356531677 | 01 | |
| LA | 1216887 | 05 |
| Street Address |
120 MEADOWCREST ST SUITE 460 |
| City | GRETNA |
| State | LA |
| Zip Code | 70056-5255 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568467769 | James P Marra | Specialist | 120 Meadowcrest St, Ste 380, Gretna, LA 70056-5281 | 2005-06-15 |
| 1851852362 | Monica Idoyaga | Nurse Practitioner | 120 Meadowcrest St, Ste 245, Gretna, LA 70056-5280 | 2019-03-27 |
| 1205379203 | Jamila Mathews | Nurse Practitioner | 120 Meadowcrest St, Gretna, LA 70056-5255 | 2016-11-22 |
| 1487084943 | Capital City Medical Group, LLC | Internal Medicine | 120 Meadowcrest St, Suite 120, Gretna, LA 70056-5255 | 2013-11-20 |
| 1336487206 | Lupin Womens Health Services, LLC | Obstetrics & Gynecology | 120 Meadowcrest St, Suite 350, Gretna, LA 70056-5255 | 2013-01-28 |
| 1700144102 | Kim Phung Thi Nguyen | Pharmacist | 120 Meadowcrest St, Suite 150, Gretna, LA 70056-5255 | 2012-04-24 |
| 1962702175 | Daniel A Long Md A Professional Medical Corporation | Clinic/Center | 120 Meadowcrest St, #330, Gretna, LA 70056-5255 | 2010-10-22 |
| 1205064631 | Ochsner Clinic LLC | Durable Medical Equipment & Medical Supplies | 120 Meadowcrest St, Gretna, LA 70056-5255 | 2009-06-24 |
| 1063648525 | Daniel J Burst | Physician Assistant | 120 Meadowcrest St, Suite 300, Gretna, LA 70056-5255 | 2009-06-10 |
| 1841431038 | Teri C Bairnsfather | Audiologist | 120 Meadowcrest St, Suite 200, Gretna, LA 70056-5255 | 2009-03-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023634169 | Krewe Wellness | Counselor | 2112 Belle Chasse Hwy Ste 8, #156, Gretna, LA 70056 | 2020-06-24 |
| 1205459732 | Gulf Coast Medical Specialists LLC | Internal Medicine | 1620 Belle Chasse Hwy Suite 101, Gretna, LA 70056 | 2020-05-19 |
| 1427530872 | Anna Marie Mckeon Jr. | Social Worker | 410 W. Butterfly Circle, Terrytown, LA 70056 | 2018-09-02 |
| 1558843219 | Nikell Thompson Fortia | Non-emergency Medical Transport (VAN) | 561 Morningside Dr, Gretna, LA 70056 | 2018-08-29 |
| 1861979379 | Irajuan L Cooley | Case Manager/Care Coordinator | 1620 Carol Sue Ave Apt 219, Gretna, LA 70056 | 2018-07-26 |
| 1457842528 | Veronica Stevenson | Case Manager/Care Coordinator | 1799 Stumpf Blvd Ste 4a, Terrytown, LA 70056 | 2018-05-24 |
| 1184126278 | Elesha Loston | Case Manager/Care Coordinator | 1799 Stumpf Blvd. Bldg .7 Suite 9a, Gretna, LA 70056 | 2018-03-05 |
| 1336656149 | Porsha D Causey | Counselor | 1799 Stumpf Blvd Bldg 7 Ste 10, Ste 10, Gretna, LA 70056 | 2018-01-02 |
| 1265950745 | Tamika Nicole Deville | Counselor | Advanced Therapeutic, 1799 Stumpf Blvd Bld 3 Ste 4b, Terrytown, LA 70056 | 2017-09-05 |
| 1679098792 | Clear Head Inc | Clinic/Center | 2310 Park Place Dr., Terrytown, LA 70056 | 2017-08-09 |
| Find all providers in zip 70056 | ||||
| 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 |
|---|---|---|---|---|
| 1255939526 | Mcdaniel Dermatology, LLC | Dermatology | 109 New Camellia Blvd Ste 200, Covington, LA 70433-7829 | 2020-10-09 |
| 1851919005 | Cenla Dermatology | Dermatology | 1587 N Bolton Ave Ste 1300, Alexandria, LA 71303-4255 | 2020-07-13 |
| 1457904658 | Advanced Skin Care | Dermatology | 3434 Prytania St Ste 420, New Orleans, LA 70115-3502 | 2019-07-17 |
| 1821551573 | Mara Haseltine Md LLC | Dermatology | 3100 Galleria Dr Ste 203, Metairie, LA 70001-2196 | 2019-04-10 |
| 1851865869 | Southern Dermatology of New Orleans | Dermatology | 2633 Napoleon Ave Ste 1020, New Orleans, LA 70115-7403 | 2019-01-14 |
| 1235643891 | Esthetic Md | Dermatology | 3769 Pontchartrain Dr Ste 3, Slidell, LA 70458-4852 | 2017-11-18 |
| 1235678558 | Family Dermatology Specialists, LLC | Dermatology | 3421 N Causeway Boulevard, Suite 202, Metairie, LA 70002-3759 | 2017-02-20 |
| 1528421872 | Joshua Mark Pitre | Dermatology | 163 Burgin Ave, Baton Rouge, LA 70808-4925 | 2016-04-04 |
| 1982098836 | Tyson Meaux | Dermatology | 101 Rue Fontaine, Lafayette, LA 70508-5744 | 2015-03-27 |
| 1447678610 | Stratton Grisoli | Dermatology | 150 Lakeview Cir, Covington, LA 70433-7512 | 2014-04-03 |
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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.