DERMATOLOGY ASSOC OF CENTRAL PA, PC (NPI# 1235224957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235224957 |
| Entity Type | Organization |
| Organization Name | DERMATOLOGY ASSOC OF CENTRAL PA, PC |
| Other Organization Name | DERMATOLOGY ASSOCIATES OF CENTRAL PA, PC |
| Practice Address |
1393 N Atherton St State College PA 16803-2932 |
| Practice Telephone | 8142386097 |
| Practice Fax Number | 8142385527 |
| Mailing Telephone | 8142386097 |
| Mailing Fax Number | 8142385527 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2011-03-26 |
| Authorized Official Name | JERRY FORREST MIKESELL (PRESIDENT) |
| Authorized Official Telephone | 8142386097 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | PA BLUE SHIELD | 413750 | 01 |
| Other Name | Type Code |
|---|---|
| Dermatology Associates of Central PA, PC | Other Name - Individual/Organization |
| Street Address |
1393 N ATHERTON ST |
| City | STATE COLLEGE |
| State | PA |
| Zip Code | 16803-2932 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730274432 | Jerry Forrest Mikesell | Dermatology | 1393 N Atherton St, State College, PA 16803-2932 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851581 | Tammy Lynn Terosky | Massage Therapist | 2134 Sandy Drive, Suite 6, State College, PA 16803 | 2020-08-12 |
| 1548748973 | Molly Gomez | Occupational Therapist | 260 Lions Hill Road, State College, PA 16803 | 2018-07-28 |
| 1568981827 | David Scott Kautz | Pharmacist | 1665 North Atherton Place, State College, PA 16803 | 2017-09-18 |
| 1245751023 | Zenovia Tarmohamed | Student in an Organized Health Care Education/Training Program | 1850 East Park Avenue, Suite 207, Penn State Health At Mount Nittany Medical Center, State College, PA 16803 | 2017-06-30 |
| 1407205362 | Alka Sood | Student in an Organized Health Care Education/Training Program | 1850 E. Park Avenue, State College, PA 16803 | 2016-06-10 |
| 1588018766 | Daniel Frankel | Student in an Organized Health Care Education/Training Program | 1850 East Park Avenue, Suite 207, State College, PA 16803 | 2016-04-14 |
| 1154791903 | Megan Widener | Physician Assistant | 2520 Green Tech Dr., Ste. D, State College, PA 16803 | 2015-10-05 |
| 1114301330 | Phuong Tran Courtney | Physician Assistant | 1613 North Atherton Street, Suite B, State College, PA 16803 | 2015-07-17 |
| 1164806840 | Amit Thatte | Student in an Organized Health Care Education/Training Program | 1850 East Park Ave., Suite 207, Penn State Hershey Medical Group, State College, PA 16803 | 2015-07-13 |
| 1245588946 | Phoenix Rehabilitation and Health Services, Inc. | Chiropractor | 1700 Old Gatesburg Road, Suite 210, State College, PA 16803 | 2012-08-28 |
| Find all providers in zip 16803 | ||||
| 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 |
|---|---|---|---|---|
| 1811973894 | Mary Amanda Jacobs | Dermatology | 200 Scenery Dr., State College, PA 16801-5602 | 2005-12-21 |
| 1992781959 | Sara B Ferguson | Dermatology | 32 Colonnade Way, State College, PA 16803-2309 | 2005-12-21 |
| 1861482788 | Mark Edward Kozminsky | Dermatology | 2505 Green Tech Dr, Suite A1, State College, PA 16803-2316 | 2005-10-22 |
| 1972020766 | Milton S Hershey Medical Center Physicians Group | Dermatology | 1850 E Park Ave Ste 207, State College, PA 16803-6706 | 2017-08-23 |
| 1841677424 | Jennifer Leigh Brooks | Dermatology | 200 Scenery Dr, State College, PA 16801-7974 | 2015-05-02 |
| 1508203811 | Cassandra Joy Simonetta | Dermatology | 32 Colonnade Way, State College, PA 16803 | 2013-05-28 |
| 1205095486 | Nicole F Velez | Dermatology | 200 Scenery Dr, State College, PA 16801-7974 | 2008-06-03 |
| 1902015597 | Matthew Allyn Hazey | Dermatology | 1850 E Park Ave Ste 312, State College, PA 16803 | 2007-05-21 |
| 1770797953 | Lorraine Rosamilia | Dermatology | 200 Scenery Dr, State College, PA 16801-7974 | 2007-05-09 |
| 1073727251 | Stacy Klepeiss | Dermatology | 200 Scenery Dr, State College, PA 16801-7974 | 2007-05-09 |
| Find all providers in STATE COLLEGE | ||||
| City | STATE COLLEGE |
| Zip Code | 16803 |
Please comment or provide details below to improve the information on DERMATOLOGY ASSOC OF CENTRAL PA, PC.
| 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.