FOREFRONT DERMATOLOGY, S.C. (NPI# 1154938579) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154938579 |
| Entity Type | Organization |
| Organization Name | FOREFRONT DERMATOLOGY, S.C. |
| Other Organization Name | ATLANTIC SHORE DERMATOLOGY, A FOREFRONT DERMATOLOGY PRACTICE |
| Practice Address |
7000 Wellness Way Ste 7120 St Simons Island GA 31522-2286 |
| Mailing Address |
801 York St Manitowoc WI 54220-4630 |
| Practice Telephone | 9126344966 |
| Practice Fax Number | 9126346542 |
| Mailing Telephone | 9206639008 |
| Mailing Fax Number | 9206841439 |
| Enumeration Date | 2020-09-29 |
| Last Update Date | 2020-10-19 |
| Authorized Official Name | DENISE ANGER (SR DIRECTOR PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 9206639022 |
| 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 | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Atlantic Shore Dermatology, A Forefront Dermatology Practice | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 400 Lister St, Waycross, GA 315015226 | 9122834850 | 9122834864 |
| 2804 Saint Marys Rd, Saint Marys, GA 315584559 | 9124393186 | 9126346542 |
| 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 |
7000 WELLNESS WAY STE 7120 |
| City | ST SIMONS ISLAND |
| State | GA |
| Zip Code | 31522-2286 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780609917 | Rachel Lauren Hawkins Duncan | Physician Assistant | 7000 Wellness Way Ste 7120, St Simons Island, GA 31522-2286 | 2006-07-12 |
| 1346621695 | Lindsey Gross Jones | Physician Assistant | 7000 Wellness Way Ste 7120, St Simons Island, GA 31522-2286 | 2015-06-12 |
| 1407866155 | Ralph Cavalier | Orthopaedic Surgery | 7000 Wellness Way Ste 7120, St Simons Island, GA 31522-2286 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982186342 | Matthew Mackinnon Gibbs | Specialist/Technologist | 211 Village Dr, St Simons Is, GA 31522 | 2018-09-02 |
| 1770957433 | Jennifer Herrin, Lpc | Community/Behavioral Health | 400 Main Street, Cottage 1, Saint Simons Island, GA 31522 | 2015-11-18 |
| 1508113002 | Ashley Neal Callicutt | Counselor | 301 Sea Island Road, Suite G, St. Simons Island, GA 31522 | 2012-08-14 |
| 1235414103 | Dana D'andrea Duggan | Psychologist | 283 Redfern Village, St. Simons Island, GA 31522 | 2011-10-11 |
| 1528394848 | Nancy Hodges Bowen | Nurse Practitioner | 7000 Wellness Way, Suite 130, St. Simons Island, GA 31522 | 2009-10-21 |
| 1073763215 | John Arthur Hendry | Dentist | 511 Mallery Street, St. Simons Island, GA 31522 | 2008-09-24 |
| 1770775116 | Randolph M. Stevens | Dentist | Coastal Endodontic Associates, 1804 Frederica Rd., Ste B, St. Simons Island, GA 31522 | 2007-08-09 |
| 1689797383 | Angela C Barnard | Nurse Practitioner | 798 Mallery St Apt 2, Saint Simons Island, GA 31522 | 2007-04-09 |
| 1053493486 | Larry D. Daugherty | Dentist | 124 Island Professional Park, St Simons Island, GA 31522 | 2006-10-19 |
| 1134239460 | Joe Neil Garner | Dentist | 288 Redfern Village, St Simons Island, GA 31522 | 2006-08-30 |
| Find all providers in zip 31522 | ||||
| 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 |
|---|---|---|---|---|
| 1912018839 | Atlantic Shore Dermatology LLC | Dermatology | 2485 Demere Rd # C100, St Simons Island, GA 31522-5634 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720686058 | Worldwide Medical Healthcare Inc | Dermatology | 790 Church St Ne Ste 300, Marietta, GA 30060-8902 | 2020-10-09 |
| 1972142891 | Worldwide Medical Distributor, LLC | Dermatology | 3780 Old Norcross Rd Ste 103, Duluth, GA 30096-1762 | 2019-12-23 |
| 1932762218 | Laura Quinn Biehle | Dermatology | 5730 Glenridge Dr Ste T100, Atlanta, GA 30328-5747 | 2019-04-22 |
| 1003479254 | Kiley Katherine Fagan | Dermatology | 775 Aronson Lake Ct, Roswell, GA 30075-7172 | 2019-04-15 |
| 1346700127 | Gerald Chotiner | Dermatology | 2887 Gant Qtrs. Circle, Marietta, GA 30068-3719 | 2019-03-20 |
| 1205308616 | Belle Lumiere Cosmetics LLC | Dermatology | 753 Old Norcross Road, Lawrenceville, GA 30046 | 2018-12-24 |
| 1154890564 | Sidney Adele Brown-caggiano | Dermatology | 4645 Timber Ridge Dr Ste 100, Douglasville, GA 30135-7542 | 2018-11-14 |
| 1194209163 | Live Oak Dermatology | Dermatology | 135 Norcross St # 8, Roswell, GA 30075-3867 | 2018-09-17 |
| 1942780994 | Skyn Clinic & Apothecary | Dermatology | 1150 Peachtree Industrial Blvd Ste 165, Suwanee, GA 30024-1903 | 2018-08-20 |
| 1649750688 | Zola Nemorin | Dermatology | 1500 Peachtree Industrial Blvd Ste 165, Suwanee, GA 30024-8490 | 2018-08-20 |
| Find all providers with the same taxonomy | ||||
| City | ST SIMONS ISLAND |
| Zip Code | 31522 |
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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.