DR. TINA RENEE KINSLEY (NPI# 1598883035) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598883035 |
| Entity Type | Individual |
| Full Name | DR. TINA RENEE KINSLEY |
| Credential | MD |
| Practice Address |
10620 Corporate Dr Fort Wayne IN 46845 |
| Mailing Address |
3702 New Vision Dr Bldg B Fort Wayne IN 46845-1703 |
| Practice Telephone | 2602668392 |
| Practice Fax Number | 2602668395 |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2019-01-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 01079530A | IN | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 4301102115 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | STATE LICENSE | 4301102115 | 01 |
| MI | NPI | 1598883035 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 37595 7 Mile Rd, Allure Dermatology, Livonia, MI 481521003 | 8005772570 |
| Street Address |
10620 CORPORATE DR |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497787659 | Keith Bryan Danckaert | Dermatology | 10620 Corporate Dr, Suite A, Fort Wayne, IN 46845-1711 | 2006-07-07 |
| 1881055069 | Forefront Dermatology, S.c. | Dermatology | 10620 Corporate Dr, Suite A, Fort Wayne, IN 46845 | 2016-03-15 |
| 1124381041 | Premier Strategies LLC | Occupational Therapist | 10620 Corporate Dr, Ste C, Fort Wayne, IN 46845-1711 | 2012-06-18 |
| 1699933267 | Lisa M. Coville | Occupational Therapist | 10620 Corporate Dr, Suite C, Fort Wayne, IN 46845-1711 | 2008-05-29 |
| 1043499221 | Dermatology and Laser Surgery Associates of Fort Wayne P.C. | Dermatology | 10620 Corporate Dr, Suite A, Fort Wayne, IN 46845-1711 | 2007-10-24 |
| 1326186966 | Sweet Peas, Inc. | Specialist | 10620 Corporate Dr, Suite C, Fort Wayne, IN 46845-1711 | 2007-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881154110 | Nancy Jean Ehmke | Clinical Nurse Specialist | 11151 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2019-03-22 |
| 1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
| 1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
| 1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
| 1811437999 | Jessica Ann Lefever | Behavioral Analyst | 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 | 2017-03-08 |
| 1033668041 | Bhi Home Care, Inc. | In Home Supportive Care | 820 Mill Lake Road, Fort Wayne, IN 46845 | 2016-10-03 |
| 1467814939 | Austin Wyss | Specialist/Technologist | 11130 Parkview Circle Drive, Ft. Wayne, IN 46845 | 2016-03-24 |
| 1154713584 | Ashley Whitcraft | Specialist/Technologist | 11130 Parkview Plaza Drive #4, Fort Wayne, IN 46845 | 2015-02-23 |
| 1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
| 1336482496 | Mithun Mohana Shenoi | Colon & Rectal Surgery | 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 | 2013-03-27 |
| Find all providers in zip 46845 | ||||
| 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 |
|---|---|---|---|---|
| 1235237074 | Diane Marie Hentz | Dermatology | 5750 Falls Dr, Fort Wayne, IN 46804-7147 | 2006-09-20 |
| 1497787659 | Keith Bryan Danckaert | Dermatology | 10620 Corporate Dr, Suite A, Fort Wayne, IN 46845-1711 | 2006-07-07 |
| 1396248415 | Jacquelyn Ray Beemer | Dermatology | 5650 Coventry Ln, Fort Wayne, IN 46804-7140 | 2018-03-15 |
| 1245686989 | Fort Wayne Integrative Medicine | Dermatology | 3919 W Jefferson Blvd, Fort Wayne, IN 46804-6811 | 2016-05-12 |
| 1881055069 | Forefront Dermatology, S.c. | Dermatology | 10620 Corporate Dr, Suite A, Fort Wayne, IN 46845 | 2016-03-15 |
| 1902291875 | Robert Stephen Bednarek | Dermatology | 11050 Parkview Circle Dr, Fort Wayne, IN 46845-1739 | 2015-03-30 |
| 1043499221 | Dermatology and Laser Surgery Associates of Fort Wayne P.C. | Dermatology | 10620 Corporate Dr, Suite A, Fort Wayne, IN 46845-1711 | 2007-10-24 |
| 1265648299 | Diana Castanon Westgate | Dermatology | 11123 Parkview Plaza Dr Ste 201, Fort Wayne, IN 46845-1707 | 2007-05-15 |
| 1730212838 | Diane Bernardi | Dermatology | 5750 Falls Dr, Fort Wayne, IN 46804-7147 | 2007-03-14 |
| 1407956923 | James Richard Kyler | Dermatology | 5750 Falls Dr, Fort Wayne, IN 46804-7147 | 2006-09-24 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46845 |
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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.