SCOTT BEALS DO PA (NPI# 1699989301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699989301 |
| Entity Type | Organization |
| Organization Name | SCOTT BEALS DO PA |
| Other Organization Name | DERMATOLOGY SURGERY CENTER |
| Practice Address |
4566 E Highway 20 Suite 101 Niceville FL 32578-8838 |
| Practice Telephone | 8508977546 |
| Practice Fax Number | 8508977547 |
| Mailing Telephone | 8508977546 |
| Mailing Fax Number | 8508977547 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2014-11-24 |
| Authorized Official Name | SCOTT L. BEALS (PHYSICIAN) |
| Authorized Official Telephone | 8508977546 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
OS7143 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | FLORIDA MEDICARE PTAN GROUP # | K4270 | 01 |
| FL | 266706100 | 05 | |
| FL | FLORIDA MEDICARE PTAN INDIVIDUAL # | 13586Y | 01 |
| Other Name | Type Code |
|---|---|
| Dermatology Surgery Center | Doing Business As Name - Organization |
| Street Address |
4566 E HIGHWAY 20 SUITE 101 |
| City | NICEVILLE |
| State | FL |
| Zip Code | 32578-8838 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326040452 | Karen Henard Carter | Chiropractor | 4566 E Highway 20, Ste 205, Niceville, FL 32578-8839 | 2005-06-01 |
| 1588103949 | Janeal T Musser | Nurse Practitioner | 4566 E Highway 20, Suite 102, Niceville, FL 32578-8838 | 2017-02-18 |
| 1023412152 | Therapeutic Connections L.L.C. | Occupational Therapist | 4566 E Highway 20, Suite 205, Niceville, FL 32578-8838 | 2014-10-17 |
| 1568886406 | James Darryl Smith | Physician Assistant | 4566 E Highway 20, Niceville, FL 32578-8838 | 2014-02-12 |
| 1093066565 | Emerald Coast Health Institute, Inc. | Clinic/Center | 4566 E Highway 20, Niceville, FL 32578-8838 | 2012-09-25 |
| 1386711885 | Catherine Mary O'connell | Nurse Practitioner | 4566 E Highway 20, Suite 101, Niceville, FL 32578-8838 | 2006-11-29 |
| 1902970197 | William Abernathy Md Pa | Internal Medicine | 4566 E Highway 20, Ste. 105, Niceville, FL 32578-8838 | 2006-11-20 |
| 1912000464 | Scott L Beals | Dermatology | 4566 E Highway 20, Suite 101, Niceville, FL 32578-8838 | 2006-09-07 |
| 1316961881 | William Abernathy | Internal Medicine | 4566 E Highway 20, Suite 105, Niceville, FL 32578-8838 | 2006-07-27 |
| 1477587145 | In Your Dreams International Inc | Psychiatry & Neurology | 4566 E Highway 20, Suite 108, Niceville, FL 32578-8838 | 2006-07-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376028563 | Southern Breeze Healthcare | Family Medicine | 4556 E Hwy 20, Suite 105, Niceville, FL 32578 | 2018-10-03 |
| 1497252860 | Molly Marie Everitt | Physician Assistant | 2190 Fl-85 N, Niceville, FL 32578 | 2018-04-11 |
| 1972009314 | Alexis Aust | Student in an Organized Health Care Education/Training Program | 104 Arrowhead Way, Niceville, FL 32578 | 2018-04-04 |
| 1518488949 | Michelle Sasala | Nurse Practitioner | 4550 E Highway 20, Niceville, FL 32578 | 2017-07-06 |
| 1003336199 | Comfortable Care Denta Health Professionals, Pa | Dentist | 1386 E John Sims Parkway, Niceville, FL 32578 | 2017-06-21 |
| 1306223888 | Emerald Coast Periodontics | Dentist | 719 Bayshore Drive, Niceville, FL 32578 | 2015-05-04 |
| 1538586136 | Pamela Ottesen Dmd LLC | Dentist | 1536 John Sims Pkwy, Niceville, FL 32578 | 2014-03-21 |
| 1417204066 | Mary Jo Stiles | Hearing Instrument Specialist | 4400 Hwy, 20 East, Suite # 211, Niceville, FL 32578 | 2012-08-13 |
| 1093086563 | Pat T. Tidwell Md Pa | Clinic/Center | 4554 Highway 20 East, Niceville, FL 32578 | 2012-01-16 |
| 1952683260 | Gentle Birth Options, LLC | Nurse Practitioner | 296 Bayshore Drive, Niceville, FL 32578 | 2011-09-13 |
| Find all providers in zip 32578 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013579002 | Alicia Nunez | Dermatology | 1000 W Broadway St Ste 206, Oviedo, FL 32765-9262 | 2019-07-01 |
| 1477114197 | Leslie Z Rohaidy | Dermatology | 55 Se 6th St Apt 3101, Miami, FL 33131-2570 | 2019-06-24 |
| 1376029579 | Gulfshore Dermatology At Coralwood, Pa | Dermatology | 326 Del Prado Blvd N Ste 301, Cape Coral, FL 33909-2288 | 2018-07-11 |
| 1033639786 | Beautysmart Dermatology Clinic and Medical Spa LLC | Dermatology | 94 S Federal Hwy, Boca Raton, FL 33432-4825 | 2017-06-23 |
| 1215319793 | Orlando Skin Institute, LLC | Dermatology | 110 Pond Ct, Ste 301, Debary, FL 32713 | 2015-06-22 |
| 1336584960 | Devorah R Shagalov | Dermatology | 3850 Hollywood Blvd Ste 403, Hollywood, FL 33021-6746 | 2013-05-09 |
| 1871834606 | Geoffrey Michael Siegel | Dermatology | 478 Alamanda Dr, Hallandale Beach, FL 33009-6508 | 2013-03-04 |
| 1174852560 | Nautilus Health Care Group, LLC | Dermatology | 5220 Belfort Rd S, Ste 130, Jacksonville, FL 32256 | 2009-12-14 |
| 1447494885 | Matteo Taerri | Dermatology | 510 Howard Ct, Sarasota, FL 34236-5050 | 2009-04-29 |
| 1336319045 | Miloslava Mician Md Pa | Dermatology | 3619 W Waters Ave, Tampa, FL 33614-2783 | 2008-03-10 |
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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.