FOREFRONT DERMATOLOGY, S.C. (NPI# 1710287503) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710287503 |
| Entity Type | Organization |
| Organization Name | FOREFRONT DERMATOLOGY, S.C. |
| Practice Address |
1245 Cheyenne Ave Suite 301 Grafton WI 53024 |
| Mailing Address |
801 York St Manitowoc WI 54220-4630 |
| Practice Telephone | 2623772222 |
| Practice Fax Number | 2623776543 |
| Mailing Telephone | 9206835278 |
| Mailing Fax Number | 9206869674 |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2018-05-17 |
| Authorized Official Name | DR. BETSY J WERNLI (PRESIDENT) |
| Authorized Official Telephone | 9204820671 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154815546 | Forefront Dermatology, S.c. | Dermatology | 7720 Us Highway 98 W Ste 240, Miramar Beach, FL 32550-7232 | 2018-06-19 |
| 1518480136 | Forefront Dermatology, S.c. | Dermatology | 8134 Old Georgetown Rd, Bethesda, MD 20814 | 2017-07-25 |
| 1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
| 1851822548 | Forefront Dermatology, S.c. | Dermatology | 1600 S Beacon Blvd, Suite 160, Grand Haven, MI 49417 | 2017-03-23 |
| 1245777994 | Forefront Dermatology, S.c. | Dermatology | 11137 U.S. 52, Brookville, IN 47012 | 2017-01-19 |
| 1982140265 | Forefront Dermatology, S.c. | Dermatology | 8567 Watson Rd, Webster Groves, MO 63119 | 2017-01-11 |
| 1386194371 | Forefront Dermatology, S.c. | Dermatology | 7200 Washington Ave, Suite 100, Mount Pleasant, WI 53406 | 2016-10-13 |
| 1356891402 | Forefront Dermatology, S.c. | Dermatology | 1515 S Green Bay Rd, Racine, WI 53406 | 2016-10-12 |
| 1619424744 | Forefront Dermatology, S.c. | Dermatology | 5700 Mexico Rd, Suite 14, Saint Peters, MO 63376 | 2016-09-07 |
| 1629524913 | Forefront Dermatology, S.c. | Dermatology | 159 S. English Station Road, Louisville, KY 40245 | 2016-08-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | FOREFRONT DERMATOLOGY, S.C., | 801 York St, Manitowoc, WI 54220 |
| Street Address |
1245 CHEYENNE AVE SUITE 301 |
| City | GRAFTON |
| State | WI |
| Zip Code | 53024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760582480 | Kelly Nicole West | Dentist | 1245 Cheyenne Ave, Suite 104, Grafton, WI 53024 | 2006-09-23 |
| 1083001622 | Kylie Mccormick | Marriage & Family Therapist | 1245 Cheyenne Ave, Grafton, WI 53024-9323 | 2015-04-21 |
| 1598188138 | Maria J. Hillmer | Registered Nurse | 1245 Cheyenne Ave, Suite 301, Grafton, WI 53024-9323 | 2014-02-03 |
| 1417284480 | West Endodontic Group | Dentist | 1245 Cheyenne Ave, Suite 104, Grafton, WI 53024-9323 | 2009-11-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245739135 | Kathy Anne Herzog | Counselor | 101 Falls Rd Suite 210, Grafton, WI 53024 | 2018-02-06 |
| 1992215867 | Caroline Marie Brandt | Nurse Practitioner | 975 Port Washington Rd Ste 310, Grafton, WI 53024 | 2017-10-05 |
| 1124569181 | Quirt Family Dentistry, Sc | Dentist | 1580 Port Washington Road, Grafton, WI 53024 | 2017-03-10 |
| 1639626260 | Jennifer Pogodzinski | Physical Therapist | 975 N. Port Washington Avenue, Grafton, WI 53024 | 2016-09-01 |
| 1750790119 | Amanda K Olejniczak | Dentist | 1505 Wisconsin Ave, Ste 130, Grafton, WI 53024 | 2014-08-10 |
| 1992053680 | Liliya Lakshtanov | Registered Nurse | 910 E. Paradise Dr., West Bend, WI 53024 | 2012-08-28 |
| 1467708446 | Trevor Holwell | Pharmacist | 1600 N Port Washington Rd, Grafton, WI 53024 | 2012-07-27 |
| 1770838120 | Brian A. Vetterkind | Physical Therapist | 2225 Wisconsin Ave Ste 100, Grafton, WI 53024 | 2012-07-20 |
| 1366774689 | Tracy Lynn Doro-krueger | Counselor | 1814 Arapaho Court, Grafton, WI 53024 | 2010-02-11 |
| 1659507754 | Karen Marie Geschke | Physical Therapist | 2020 Cheyenne Ct., Grafton, WI 53024 | 2009-06-03 |
| Find all providers in zip 53024 | ||||
| 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 |
|---|---|---|---|---|
| 1083843114 | Alexandra Cameli Carley | Dermatology | 215 Washington St, Grafton, WI 53024-1700 | 2009-07-10 |
| 1164691689 | W J Shields M D | Dermatology | 914 Denbigh Blvd, Grafton, VA 23692-2156 | 2008-02-28 |
| 1598792947 | John D. Yadgir | Dermatology | 215 Washington St, Grafton, WI 53024-1700 | 2006-06-28 |
| 1992768253 | William Jennings Shields | Dermatology | 914 Denbigh Blvd, Grafton, VA 23692 | 2006-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174016596 | Dermatology and Cosmetic Physicians, Sc | Dermatology | W5192 Rienzi Rd, Fond Du Lac, WI 54935-9603 | 2018-06-11 |
| 1194248013 | Kyle Erick Rudningen | Dermatology | Uw Hosptials & Clinics 600 Highland Ave, Madison, WI 53792 | 2017-07-23 |
| 1194255521 | Rhonda Ganansky | Dermatology | W1383 N Bloomfield Rd, Lake Geneva, WI 53147-4429 | 2017-06-18 |
| 1356891402 | Forefront Dermatology, S.c. | Dermatology | 1515 S Green Bay Rd, Racine, WI 53406 | 2016-10-12 |
| 1982066239 | Margaret Coleman Maxi | Dermatology | 188 Rockwood Ln Ste A, Neenah, WI 54956-1983 | 2016-03-25 |
| 1447612312 | Andrew C Duncanson | Dermatology | 510 N 17th Ave Ste C, Wausau, WI 54401-4281 | 2016-03-22 |
| 1225411481 | Gabriela A Maloney | Dermatology | 17100 W North Ave Ste 200, Brookfield, WI 53005-4489 | 2015-07-07 |
| 1043604424 | Marthe Ngongang Dika | Dermatology | 10500 W Loomis Rd Ste 110, Franklin, WI 53132-8030 | 2015-03-24 |
| 1902205206 | Affiliated Dermatologists | Dermatology | N96w17035 Division Rd, Suite A, Germantown, WI 53022-6419 | 2014-08-22 |
| 1568882793 | Kassandra E Holzem | Dermatology | 195 Discovery Dr, Brookfield, WI 53045 | 2014-04-28 |
| Find all providers with the same taxonomy | ||||
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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.