JONATHAN A DYER (NPI# 1376591073) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376591073 |
| Entity Type | Individual |
| Full Name | JONATHAN A DYER |
| Credential | MD |
| Practice Address |
1101 Hospital Dr Columbia MO 65212-0001 |
| Mailing Address |
Po Box 7687 Columbia MO 65205-7687 |
| Practice Telephone | 5738824800 |
| Practice Fax Number | 5738845947 |
| Mailing Telephone | 5738822259 |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2011-05-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 2001014980 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | HEALTHLINK | 658400 | 01 |
| MO | BLUE SHIELD/BLUE CHOICE | 189164 | 01 |
| MO | UNITED HEALTHCARE | 300639 | 01 |
| MO | 209312404 | 05 |
| Street Address |
1101 HOSPITAL DR |
| City | COLUMBIA |
| State | MO |
| Zip Code | 65212-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205111549 | Mu Student Health Center | Clinic/Center | 1101 Hospital Dr, Columbia, MO 65212-0001 | 2011-10-19 |
| 1063791432 | Shalonda Banks Covington | Nurse Practitioner | 1101 Hospital Dr, Columbia, MO 65212-0001 | 2011-08-16 |
| 1316266836 | Gretchen Reinders | Psychologist | 1101 Hospital Dr, Columbia, MO 65212-0001 | 2010-05-24 |
| 1902031834 | Eric Darren Johnson | Physician Assistant | 1101 Hospital Dr, Columbia, MO 65212-0001 | 2009-05-21 |
| 1376749127 | Padmaja Vasireddy | Psychiatry & Neurology | 1101 Hospital Dr, Columbia, MO 65212-0001 | 2007-06-26 |
| 1972652238 | Susan Elizabeth O'neill | Psychologist | 1101 Hospital Dr, Dc800.00, Columbia, MO 65212-0001 | 2007-01-09 |
| 1356402242 | Theresa Wilson | Registered Nurse | 1101 Hospital Dr, Columbia, MO 65212-0001 | 2006-12-13 |
| 1073671020 | Lynn Ann Rossy | Counselor | 1101 Hospital Dr, Dc800.00, Columbia, MO 65212-0001 | 2006-12-04 |
| 1124196332 | Kim M Webb | Student in an Organized Health Care Education/Training Program | 1101 Hospital Dr, Columbia, MO 65212-0001 | 2006-12-04 |
| 1902979172 | Deborah Ann Johnoff | Nurse Practitioner | 1101 Hospital Dr, Student Health Center, Columbia, MO 65212-0001 | 2006-11-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225594112 | Hee Young Lee | Student in an Organized Health Care Education/Training Program | 1100 Virginia Avenue, University of Missouri Health Car, Columbia, MO 65212 | 2019-02-15 |
| 1093200966 | Alexander John Lubinski | Radiology | 1 Hospital Drive Dco6910, Columbia, MO 65212 | 2018-06-24 |
| 1235638156 | Jami Bates | Physician Assistant | University of Missouri Hospital 1 Hospital Drive, Columbia, MO 65212 | 2018-02-06 |
| 1124554589 | John Wuennenberg | Student in an Organized Health Care Education/Training Program | 1020 Hitt St 2nd Floor, Columbia, MO 65212 | 2017-05-04 |
| 1336672005 | William Paul Christensen | Physical Medicine & Rehabilitation | One Hospital Dr Dc046.00, Dc046.00, Columbia, MO 65212 | 2017-04-09 |
| 1881127108 | Kelli Danielle Bryant | Student in an Organized Health Care Education/Training Program | 1020 Hitt St 2nd Florr, Columbia, MO 65212 | 2017-04-04 |
| 1952832859 | Juhi Koolwal | Radiology | 1 Hospital Dirve Ddc06910, Columbia, MO 65212 | 2017-03-22 |
| 1518319136 | Joseph Patrick Herbert | Neurological Surgery | One Hospital Drive, Dc048.00, Mc314 Mchaney Hall, Columbia, MO 65212 | 2016-07-07 |
| 1407207319 | Jesse Schmid | Otolaryngology | One Hosital Dr Ma314, Columbia, MO 65212 | 2016-06-22 |
| 1508216920 | David Koch | Radiology | 1 Hospital Drive, Dc06910, Columbia, MO 65212 | 2016-06-16 |
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| 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 |
|---|---|---|---|---|
| 1528537057 | Cayce Medical Spa, Inc | Dermatology | 2001 Corona Rd Ste 201, Columbia, MO 65203-5924 | 2018-11-14 |
| 1366946832 | Novahealth Medical Group, LLC | Dermatology | 3208 Lemone Industrial Blvd Ste A, Columbia, MO 65201-8244 | 2018-03-20 |
| 1508248576 | Kaitlin Ann Schiavo | Dermatology | 204 N Keene St Ste 100, Columbia, MO 65201-8136 | 2015-06-25 |
| 1588041289 | Megan Casady | Dermatology | 10710 Charter Dr Ste 420, Columbia, MD 21044-3276 | 2015-05-01 |
| 1104239037 | Ashley Miles Jenkins | Dermatology | 1000 W Nifong Blvd Ste 150, Columbia, MO 65203-5615 | 2014-06-09 |
| 1497000723 | Leslie Brooke Mills | Dermatology | 2011 Corona Rd Ste 207, Columbia, MO 65203-2548 | 2012-07-24 |
| 1225397458 | Wynn Kao Dermatology, LLC | Dermatology | 10705 Charter Dr Ste 330, Columbia, MD 21044-2885 | 2012-05-08 |
| 1073811253 | Edward Shmunes | Dermatology | 3701 Northshore Rd, Columbia, SC 29206-3365 | 2011-03-11 |
| 1316178346 | M.r. Taylor Rayburn, Jr. M.d. P.C. | Dermatology | 1411 Hatcher Ln, Columbia, TN 38401-3535 | 2009-08-08 |
| 1518193630 | Chesahna Kindred | Dermatology | 8900 Columbia 100 Pkwy Ste F, Columbia, MD 21045-2336 | 2009-06-03 |
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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.