FOREFRONT DERMATOLOGY, S.C. (NPI# 1730560079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730560079 |
| Entity Type | Organization |
| Organization Name | FOREFRONT DERMATOLOGY, S.C. |
| Practice Address |
415 S Landmark Ave Bloomington IN 47403-5003 |
| Mailing Address |
801 York St Manitowoc WI 54220-4630 |
| Practice Telephone | 8123337433 |
| Practice Fax Number | 8123337435 |
| Mailing Telephone | 8666309882 |
| Mailing Fax Number | 9206825810 |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2018-05-16 |
| 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 | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians | ||
| 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 |
415 S LANDMARK AVE |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47403-5003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902450117 | Emily Kay Lutz | Physician Assistant | 415 S Landmark Ave, Bloomington, IN 47403-5003 | 2019-07-25 |
| 1154843100 | Emily Williams | Physician Assistant | 415 S Landmark Ave, Bloomington, IN 47403-5003 | 2017-07-12 |
| 1003264300 | Steven Meeks | Physician Assistant | 415 S Landmark Ave, Bloomington, IN 47403-5003 | 2016-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043783673 | Brook Whitaker | Registered Nurse | 4011 S. Monroe Medical Park Blvd, Bloomington, IN 47403 | 2019-01-07 |
| 1598251175 | Jacob Edward Lundorf | Nurse Practitioner | 2100 S Liberty Dr Ste B, Bloomington, IN 47403 | 2018-07-06 |
| 1568973717 | Gregory Thomas Dougan | Physician Assistant | 418 South Landmark Avenue, Bloomington, IN 47403 | 2017-10-16 |
| 1295276160 | Indiana Center for Recovery, LLC | Substance Abuse Rehabilitation Facility | 1004 W 1st Street, Bloomington, IN 47403 | 2017-03-13 |
| 1144694217 | Kayla Dewolf | Specialist/Technologist | 1471 W Allen St, Bloomington, IN 47403 | 2015-11-30 |
| 1164806444 | Monroe Hosoital | General Acute Care Hospital | 4011 Monroe Medical Park, Bloomington, IN 47403 | 2015-07-16 |
| 1821411588 | Jennifer Turner | Occupational Therapy Assistant | 1023 West Main St, Swiss Villa, Vevay, IN 47403 | 2014-01-30 |
| 1104170232 | Kendall Basore | Social Worker | 445 S. Landmark Ave., Bloomington, IN 47403 | 2012-10-26 |
| 1568715886 | Indiana Hearing LLC | Hearing Aid Equipment | 2019 S Liberty Dr, Bloomington, IN 47403 | 2012-10-24 |
| 1679870232 | Accurate Hearing Services | Clinic/Center | 1355 W Second St, #3, Bloomington, IN 47403 | 2011-02-17 |
| Find all providers in zip 47403 | ||||
| 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 |
|---|---|---|---|---|
| 1740415777 | Adrienne Schupbach | Dermatology | 3024 E Empire St Ste E&f, Bloomington, IL 61704-5402 | 2009-05-19 |
| 1003914920 | Bloomington Dermatology Clinic | Dermatology | 2001 E 3rd St, Bloomington, IN 47401-7890 | 2006-09-21 |
| 1528008414 | Rajagopala Swaminathan | Dermatology | 3024 E Empire St Ste Eandf, Bloomington, IL 61704-5402 | 2006-06-08 |
| 1366442444 | Kent S. Taulbee | Dermatology | 2418 E Lincoln St, Bloomington, IL 61701-5915 | 2005-07-29 |
| 1578567343 | Mary Kathleen Mctigue | Dermatology | 1200 S Rogers St, Bloomington, IN 47403-4792 | 2005-06-09 |
| 1184000531 | Roxanne Rajaii | Dermatology | 1200 S Rogers St, Bloomington, IN 47403-4792 | 2015-08-08 |
| 1669867669 | Michelle Gita Baechtold | Dermatology | 1200 S Rogers St, Bloomington, IN 47403-4792 | 2015-04-06 |
| 1144489618 | Elizabeth Kim Farhat | Dermatology | 7920 Old Cedar Ave S, Bloomington, MN 55425-1207 | 2008-06-09 |
| 1801063128 | Carrie Lynn Davis | Dermatology | 1200 S Rogers St, Bloomington, IN 47403-4792 | 2008-05-15 |
| 1689846909 | Talley Bhanyang Whang | Dermatology | 1200 S Rogers St, Bloomington, IN 47403-4792 | 2008-03-26 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 47403 |
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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.