BLUE ASH DERMATOLOGY, LLC (NPI# 1679016745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679016745 |
| Entity Type | Organization |
| Organization Name | BLUE ASH DERMATOLOGY, LLC |
| Practice Address |
9403 Kenwood Rd Ste B100 Blue Ash OH 45242-6895 |
| Practice Telephone | 5138918045 |
| Practice Fax Number | 5138918110 |
| Mailing Telephone | 5138918045 |
| Mailing Fax Number | 5138918110 |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2017-05-24 |
| Authorized Official Name | SAMIR B PATEL (OWNER) |
| Authorized Official Telephone | 5137704212 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0209139 | 05 |
| Street Address |
9403 KENWOOD RD STE B100 |
| City | BLUE ASH |
| State | OH |
| Zip Code | 45242-6895 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891394615 | Rosemary Le Master | Counselor | 9403 Kenwood Rd, Blue Ash, OH 45242-6895 | 2020-10-22 |
| 1407455835 | Amy S Medrano | Counselor | 9403 Kenwood Rd, Blue Ash, OH 45242-6895 | 2020-10-17 |
| 1093329500 | Kendra R Nickell | Counselor | 9403 Kenwood Rd, Blue Ash, OH 45242-6895 | 2020-09-02 |
| 1881204469 | Amada S Block | Registered Nurse | 9403 Kenwood Rd, Blue Ash, OH 45242-6895 | 2020-08-07 |
| 1619585767 | Ashley B Melton | Counselor | 9403 Kenwood Rd, Blue Ash, OH 45242-6895 | 2020-07-15 |
| 1386262855 | Jodi Grooms | Counselor | 9403 Kenwood Rd, Blue Ash, OH 45242-6895 | 2020-07-10 |
| 1396362588 | Lisa Ennix | Licensed Practical Nurse | 9403 Kenwood Rd, Blue Ash, OH 45242-6895 | 2020-07-03 |
| 1700402351 | Gregory M Blakley | Counselor | 9403 Kenwood Rd, Blue Ash, OH 45242-6895 | 2020-06-19 |
| 1588288393 | Jennifer C Jarman | Registered Nurse | 9403 Kenwood Rd, Blue Ash, OH 45242-6895 | 2020-06-08 |
| 1831713627 | Jessica Renee Godby | Counselor | 9403 Kenwood Rd, Blue Ash, OH 45242-6895 | 2020-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162533 | D&c Enhanced Home Healthcare Agency | Licensed Practical Nurse | 10999 Reed Hartman Hwy Ste 326, Blue Ash, OH 45242 | 2020-10-21 |
| 1487251088 | Calvary Behavioral Health of Ohio, LLC | Community/Behavioral Health | 11974 State Route 42, Suite 240, Sharonville, OH 45242 | 2020-10-06 |
| 1093324352 | Hotel California By The Sea Cincinnati, LLC. | Substance Abuse Rehabilitation Facility | 7745 Ivygate Lane, Cincinnati, OH 45242 | 2020-07-23 |
| 1265040554 | Hotel California By The Sea Cincinnati, LLC. | Substance Abuse Rehabilitation Facility | 7172 Pfeiffer Road, Cincinnati, OH 45242 | 2020-07-22 |
| 1144838442 | Hotel California By The Sea Cincinnati, LLC. | Substance Abuse Rehabilitation Facility | 10519 Cinderella Drive, Cincinnati, OH 45242 | 2020-07-22 |
| 1841836830 | Alms Social Services | Community/Behavioral Health | 11071 Oak Avenue, Cincinnati, OH 45242 | 2019-11-25 |
| 1740839398 | Vibrant Care LLC | In Home Supportive Care | 1099 Reed Hartman Hwy, Suite 332, Cincinnati, OH 45242 | 2019-09-06 |
| 1902368988 | Twin Lakes | Assisted Living Facility | 9840 Montgomery Road, Attn: Lec Finance, Cincinnati, OH 45242 | 2019-04-01 |
| 1215496344 | Cathy L Rosenbaum | Pharmacist | 10274 Alliance Road, Blue Ash, OH 45242 | 2019-03-18 |
| 1841773181 | Accelerated Rehabilitation Centers Ltd | Physical Therapist | 9856 Montgomery Rd #300, Cincinnati, OH 45242 | 2018-09-12 |
| Find all providers in zip 45242 | ||||
| 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 |
|---|---|---|---|---|
| 1275982746 | Samantha N Barry | Dermatology | 9403 Kenwood Rd Ste B100, Blue Ash, OH 45242-6858 | 2016-06-06 |
| 1184600520 | Ruth L. Kleier | Dermatology | 9844 Redhill Dr, Blue Ash, OH 45242-5627 | 2005-12-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023623808 | Bria Deshea Barjuca | Dermatology | 4450 Eastgate Blvd Ste 232, Cincinnati, OH 45245-1788 | 2020-09-09 |
| 1184263675 | Sunkiss Essentials LLC | Dermatology | 2926 State Rd Ste 369, Cuyahoga Falls, OH 44223-1244 | 2019-12-31 |
| 1770048894 | Teresa O'connell | Dermatology | Timeless Skin Solutions, 31 South High St, Dublin, OH 43017 | 2019-02-02 |
| 1144737560 | Robert Brody Md Co | Dermatology | 3461 Warrensville Center Rd Ste 101, Shaker Heights, OH 44122-5227 | 2018-01-08 |
| 1366893752 | Kirsten Dickinson | Dermatology | Cleveland Clinic 9500 Euclin Ave, Cleveland, OH 44195-1009 | 2016-06-27 |
| 1649629692 | Megan Ashley Jones-sheets | Dermatology | 75 Metro Place North, Suite 195, Dublin, OH 43017 | 2016-06-10 |
| 1720433592 | Nitin Tiwari | Dermatology | 4439 State Route 159 Ste G50, Chillicothe, OH 45601-7202 | 2016-04-29 |
| 1487008751 | Kiyanna Marie Williams | Dermatology | 2049 E 100th St A Building, Cleveland, OH 44195-1014 | 2016-04-22 |
| 1336502038 | Jacqueline Graham | Dermatology | 566 White Pond Dr Ste E, Akron, OH 44320-1116 | 2016-03-30 |
| 1124426135 | Greater Cleveland Dermatology Group Inc | Dermatology | 1440 Rockside Rd Ste 220, Cleveland, OH 44134-2749 | 2014-12-08 |
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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.