BRISTOL DERMATOLOGY, PLLC (NPI# 1669662516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669662516 |
| Entity Type | Organization |
| Organization Name | BRISTOL DERMATOLOGY, PLLC |
| Practice Address |
350 Blountville Hwy Suite 201 Bristol TN 37620-0213 |
| Practice Telephone | 4232171337 |
| Practice Fax Number | 4232171249 |
| Mailing Telephone | 4232171337 |
| Mailing Fax Number | 4232171249 |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2009-09-01 |
| Authorized Official Name | DR. KENNETH RAY WARRICK (PRESIDENT) |
| Authorized Official Telephone | 8035467522 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
40472 | TN | Allopathic & Osteopathic Physicians |
| Y | 207N00000X | Dermatology | 40472 | TN | Allopathic & Osteopathic Physicians |
| Street Address |
350 BLOUNTVILLE HWY SUITE 201 |
| City | BRISTOL |
| State | TN |
| Zip Code | 37620-0213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386625663 | Charles H. Christ | Dentist | 350 Blountville Hwy, Suite 202, Bristol, TN 37620-0213 | 2005-11-14 |
| 1194015412 | Stephen K Evans | Anesthesiology | 350 Blountville Hwy, Suite 207, Bristol, TN 37620-0213 | 2011-04-08 |
| 1922238849 | Correct Hearing Inc | Audiologist-Hearing Aid Fitter | 350 Blountville Hwy, Suite 102, Bristol, TN 37620-0213 | 2009-07-27 |
| 1255593356 | Bristol Surgery Center | Clinic/Center | 350 Blountville Hwy, Suite 108, Bristol, TN 37620-0213 | 2008-06-30 |
| 1679731269 | Michael August Long | Anesthesiology | 350 Blountville Hwy, #207, Bristol, TN 37620-0213 | 2008-05-30 |
| 1912174194 | Jayson C. Smith | Dentist | 350 Blountville Hwy, Suite 202, Bristol, TN 37620-0213 | 2008-05-15 |
| 1134391154 | Donald S. Redford, D.d.s, P.c | Dentist | 350 Blountville Hwy, Suite 204, Bristol, TN 37620-0213 | 2008-03-31 |
| 1699975623 | Renee D Dixon | Nurse Anesthetist, Certified Registered | 350 Blountville Hwy, Suite 207, Bristol, TN 37620-0213 | 2007-07-18 |
| 1215136429 | Brandace L Golden | Nurse Anesthetist, Certified Registered | 350 Blountville Hwy, Suite 207, Bristol, TN 37620-0213 | 2007-07-17 |
| 1164621371 | Amanda Suzanne Gaither | Nurse Anesthetist, Certified Registered | 350 Blountville Hwy, Suite 207, Bristol, TN 37620-0213 | 2007-07-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376180216 | Firstep, LLC | Psychiatry & Neurology | 3183 W. State St., Suite 1201, Bristol, TN 37620 | 2019-12-10 |
| 1578047726 | Amanda Harville Mcgrady | Psychologist | 105 Walnut Circle, Bristol, TN 37620 | 2018-09-23 |
| 1467932533 | Teresa Mooney | Nurse Practitioner | 324 Leslie Ct, Bristol, TN 37620 | 2018-08-17 |
| 1992285308 | Jeremy Aurbrey Blanzy | Nurse Practitioner | 1 Medical Park Boulevard, Suite 400e, Bristol, TN 37620 | 2018-08-15 |
| 1255841805 | Amanda L Pillion | Audiologist | 225 Midway Medical Park, Bristol, VA 37620 | 2017-10-10 |
| 1841717717 | Joel Blevins | Driver | 301 Webb Ct, Bristol, TN 37620 | 2017-08-23 |
| 1831579796 | Dr. Marie Crawford, Ph.d., Pllc | Psychologist | 739 Bluff City Highway, Suite 5, Bristol, TN 37620 | 2015-06-05 |
| 1508297169 | Cassandra Marie Conry | Chiropractor | 800 Hill St., Bristol, TN 37620 | 2013-12-09 |
| 1780025874 | Laura Leann Lawson-renfro | Nurse Practitioner | 260 Midway St, Bristol, TN 37620 | 2013-07-17 |
| 1760822365 | Ricky Bhimani | Internal Medicine | 208 Medical Park Boulevard, Bristol, TN 37620 | 2013-06-27 |
| Find all providers in zip 37620 | ||||
| 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 |
|---|---|---|---|---|
| 1841365681 | Glenn Stanton Gart | Dermatology | 255 North Main Street, Bristol, CT 06010 | 2006-11-21 |
| 1861497620 | Tanya Chiarelli Ave'lallemant | Dermatology | 72 Pine St, Unit 3, Bristol, CT 06010-6960 | 2005-06-17 |
| 1265721054 | Reuben Harel Reich | Dermatology | 1180 Hope St, Bristol, RI 02809-1126 | 2011-04-01 |
| 1871709147 | Grace Dolores Bandow | Dermatology | 1180 Hope St, Bristol, RI 02809-1126 | 2007-05-15 |
| 1962533661 | William J. Schermer Pllc | Dermatology | 3183 W State St, Suite 1102, Bristol, TN 37620-1712 | 2007-03-07 |
| 1467430231 | William John Schermer | Dermatology | 3183 W State St, Suite 1102, Bristol, TN 37620-1712 | 2006-01-03 |
| 1538161161 | Medical Associates of Ri Inc | Dermatology | 1180 Hope St, Bristol, RI 02809-1126 | 2005-08-12 |
| 1568463115 | Medical Associates of Rhode Island Inc. | Dermatology | 1180 Hope St, Bristol, RI 02809-1126 | 2005-08-04 |
| 1891796702 | Gwenn Maria Vittimberga | Dermatology | 1180 Hope St, Bristol, RI 02809-1126 | 2005-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356964274 | Harpeth Valley Dermatology Pllc | Dermatology | 741 President Pl Ste 140, Smyrna, TN 37167-6808 | 2020-05-27 |
| 1538717202 | Christopher Reeder | Dermatology | 6453 Drumright Rd, College Grove, TN 37046-9142 | 2019-08-27 |
| 1346719085 | Skinmd Center Pllc | Dermatology | 751 Walnut Knoll Lane, Suite 2, Cordova, TN 38018-6301 | 2018-11-23 |
| 1467968859 | Outreach Clinics Unlimited Pllc | Dermatology | 1627 Old Gray Station Rd Ste 4, Johnson City, TN 37615-4193 | 2017-12-20 |
| 1295289114 | Firstcare Dermatology of Lawrenceburg, Pllc | Dermatology | 1002 N Locust Ave, Lawrenceburg, TN 38464-2707 | 2016-08-09 |
| 1790158012 | Joseph Prohaska | Dermatology | 1907 W Morris Blvd Ste G, Morristown, TN 37813-3866 | 2015-11-09 |
| 1346637048 | Jonathan Allen Miller | Dermatology | 5243 Little Debbie Pkwy Ste 111, Ooltewah, TN 37363-4515 | 2015-04-20 |
| 1073909156 | Neelam Patel | Dermatology | 470 Jones Rd, Clarksville, TN 37043-4005 | 2015-04-15 |
| 1013315373 | Robert J Kaplan, Md Pllc | Dermatology | 6401 Poplar Ave Ste 330, Memphis, TN 38119-4806 | 2014-12-18 |
| 1538575709 | Emily Dell | Dermatology | 1009 N State of Franklin Rd, Johnson City, TN 37604 | 2014-07-08 |
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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.