REGIONAL DERMATOLOGY, LLC (NPI# 1396064879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396064879 |
| Entity Type | Organization |
| Organization Name | REGIONAL DERMATOLOGY, LLC |
| Practice Address |
1463 Highway 61 Suite B Festus MO 63028-4109 |
| Practice Telephone | 6369337600 |
| Practice Fax Number | 6369335900 |
| Mailing Telephone | 6369337600 |
| Mailing Fax Number | 6369335900 |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2010-05-24 |
| Authorized Official Name | DR. SARAH L JENSEN (OWNER) |
| Authorized Official Telephone | 6369337600 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 2006031051 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 206872806 | 05 |
| Street Address |
1463 HIGHWAY 61 SUITE B |
| City | FESTUS |
| State | MO |
| Zip Code | 63028-4109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134381999 | Nagireddi Pediatrics LLC | Pediatrics | 1463 Highway 61, Suite # C, Festus, MO 63028-4109 | 2008-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952943268 | Lauryn E Morris | Occupational Therapist | 3657 Baptist Park Rd, Mapaville, MO 63028 | 2019-10-09 |
| 1912557547 | Rena Robinson | Technician | 150 Brandon Wallace Way Suite 1014, Suite 1014, Festus, MO 63028 | 2019-09-16 |
| 1780232264 | Cynthia L James | Technician | 110 Juliet Place, Festus, MO 63028 | 2019-08-28 |
| 1700377009 | Akr Endodontics, LLC | Dentist | 1431 Us Hwy 61, Festus, MO 63028 | 2018-05-22 |
| 1962869990 | Fatma Esen Antakli | Nurse Practitioner | Advanced Pain Centers 190 Industrial Drive, Festus, MO 63028 | 2016-01-21 |
| 1083088744 | Megan Schomer | Counselor | 2675 Meyer Rd, Festus, MO 63028 | 2015-11-18 |
| 1043608144 | Elka Follmer | Physical Therapist | 1349 Us Hwy 61, Festus, MO 63028 | 2014-12-26 |
| 1811394729 | Ashley Schwendeman | Physical Therapist | 1403 N. Truman Blvd, Fesuts, MO 63028 | 2014-11-21 |
| 1073871257 | Staurla Chantel Waun | Counselor | 10719 Buckeye Rd, Festus, MO 63028 | 2012-04-25 |
| 1639444086 | Jeffrey Steitz | Otolaryngology | 1390 Us Highway 61 Ste 3100, Festus, MO 63028 | 2012-03-19 |
| Find all providers in zip 63028 | ||||
| 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 |
|---|---|---|---|---|
| 1639119175 | Sarah L Jensen | Dermatology | 1463 Hwy 61, Suite B, Festus, MO 63028 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922605906 | Deluxe Dermatology LLC | Dermatology | 1034 S Brentwood Blvd Ste 1000, Saint Louis, MO 63117-1210 | 2020-10-03 |
| 1811510886 | Yoon Dermatology LLC | Dermatology | 1060 Meyer Rd, Wentzville, MO 63385-3800 | 2020-05-25 |
| 1417597923 | Anna Marie Aiazzi | Dermatology | 10012 Kennerly Rd Ste 401, Saint Louis, MO 63128-2197 | 2020-01-13 |
| 1790330371 | Baydon Earl Hilton | Dermatology | 1003 Kings Rd, Kirksville, MO 63501-2627 | 2019-08-09 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1528537057 | Cayce Medical Spa, Inc | Dermatology | 2001 Corona Rd Ste 201, Columbia, MO 65203-5924 | 2018-11-14 |
| 1396226981 | Nicole Betty | Dermatology | 413 W Water Street, Greenfield, MO 65661 | 2018-08-22 |
| 1366946832 | Novahealth Medical Group, LLC | Dermatology | 3208 Lemone Industrial Blvd Ste A, Columbia, MO 65201-8244 | 2018-03-20 |
| 1952757007 | Stacy Gittel Blum | Dermatology | 222 S Woods Mill Rd Ste 480, Chesterfield, MO 63017-3625 | 2016-05-08 |
| 1508248576 | Kaitlin Ann Schiavo | Dermatology | 204 N Keene St Ste 100, Columbia, MO 65201-8136 | 2015-06-25 |
| Find all providers with the same taxonomy | ||||
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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.