DERMATOLOGY & SURGERY OF SOUTHERN OHIO, INC. (NPI# 1952349466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952349466 |
| Entity Type | Organization |
| Organization Name | DERMATOLOGY & SURGERY OF SOUTHERN OHIO, INC. |
| Practice Address |
1213 Nilles Rd Fairfield OH 45014-2911 |
| Mailing Address |
Po Box 633048 Cincinnati OH 45263-3048 |
| Practice Telephone | 5138586900 |
| Practice Fax Number | 5138586903 |
| Mailing Telephone | 5138586900 |
| Mailing Fax Number | 5138586903 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2010-07-20 |
| Authorized Official Name | JONI PROFT (OFFICE ADMINISTRATOR) |
| Authorized Official Telephone | 5138586900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
35060409 | OH | Allopathic & Osteopathic Physicians |
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
35060409 | OH | Allopathic & Osteopathic Physicians |
| N | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
35060409 | OH | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
35060409 | OH | Allopathic & Osteopathic Physicians |
| Y | 207N00000X | Dermatology | 35060409 | OH | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235442211 | Dermatology & Surgery of Southern Ohio, Inc. | Dermatology | 7132 Cincinnati Dayton Rd, Suite 200, Liberty Townshp, OH 45069-1775 | 2010-07-20 |
| Street Address |
1213 NILLES RD |
| City | FAIRFIELD |
| State | OH |
| Zip Code | 45014-2911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699713107 | Scott Charles Grevey | Dermatology | 1213 Nilles Rd, Fairfield, OH 45014-2911 | 2006-06-04 |
| 1760022560 | Tamara Tincher | Nurse Practitioner | 1213 Nilles Rd, Fairfield, OH 45014-2911 | 2020-01-09 |
| 1063746626 | Jessica P Watkins | Physician Assistant | 1213 Nilles Rd, Fairfield, OH 45014-2911 | 2009-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326526872 | Megan Coleen Hamill | Registered Nurse | 6570 Sosna Drive, Fairfield, OH 45014 | 2018-08-06 |
| 1831695642 | James Grant Walther | Contractor | 16408 Jeanie Drive, Aurora, IN 45014 | 2018-04-02 |
| 1104339837 | Tamara Rochester | Registered Nurse | 5474 Yellowstone Dr, Fairfield, OH 45014 | 2017-11-16 |
| 1104335892 | Barbara Johnson | Registered Nurse | 2853 Saturn Drive, Fairfield, OH 45014 | 2017-09-25 |
| 1205373537 | Samuel E Ghee IIi | Counselor | Decoach Rehabilitation Center, 6570 Sosna Drive, Fairfield, OH 45014 | 2017-01-25 |
| 1669916789 | Lacretia Ancona | In Home Supportive Care | 700 Wessel Dr #181505, Fairfield, OH 45014 | 2016-12-08 |
| 1134676299 | Lynne Mutuku | Licensed Practical Nurse | 3975 Woodridge Blvd, Apt 10, Fairfield, OH 45014 | 2016-09-07 |
| 1104291020 | Mimi Supportive Hands .llc | Home Health | 6 Ridge Dr Apt 203, Cincinnati, OH 45014 | 2015-12-03 |
| 1215319181 | Brittany Beck | Social Worker | 3050 Mack Rd Ste 205, Fairfield, OH 45014 | 2015-06-26 |
| 1093193278 | Ashli Tanner | Specialist/Technologist | 8790 N. Gilmore Rd., Fairfield, OH 45014 | 2015-05-08 |
| Find all providers in zip 45014 | ||||
| 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 |
|---|---|---|---|---|
| 1053554667 | Brittany Craiglow | Dermatology | 140 Sherman St Fl 3, Fairfield, CT 06824-5849 | 2009-04-13 |
| 1699713107 | Scott Charles Grevey | Dermatology | 1213 Nilles Rd, Fairfield, OH 45014-2911 | 2006-06-04 |
| 1649217936 | Karl Reinhard Beutner | Dermatology | 480 Chadbourne Rd, Suite 201, Fairfield, CA 94534-9647 | 2006-06-02 |
| 1063822237 | Dorota Zuzanna Korta | Dermatology | 2720 Low Ct, Fairfield, CA 94534-9771 | 2014-04-28 |
| 1073937835 | Robert Sorensen | Dermatology | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2014-02-13 |
| 1851699532 | Bien-aimee Vu Lau | Dermatology | 2720 Low Ct, Fairfield, CA 94534-9771 | 2011-03-04 |
| 1346488699 | Solano Dermatology Associates Inc | Dermatology | 480 Chadbourne Rd, Ste 201, Fairfield, CA 94534-9647 | 2009-01-25 |
| 1750545620 | Ingrid C. Freeny | Dermatology | 2720 Low Court, Fairfield, CA 94534 | 2008-07-10 |
| 1528226750 | Elizabeth Corr Anderson Smith | Dermatology | 1305 Post Rd, Suite 310, Fairfield, CT 06824-6016 | 2008-05-23 |
| 1649492752 | Jason Carl Mcbean | Dermatology | 1305 Post Rd, Suite 310, Fairfield, CT 06824-6016 | 2007-05-02 |
| Find all providers in FAIRFIELD | ||||
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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.