DUBOIS REGIONAL MEDICAL CENTER - PENN HIGHLANDS DERMATOLOGY (NPI# 1740665652) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740665652 |
| Entity Type | Organization |
| Organization Name | DUBOIS REGIONAL MEDICAL CENTER - PENN HIGHLANDS DERMATOLOGY |
| Other Organization Name | PENN HIGHLANDS DUBOIS |
| Practice Address |
90 Beaver Dr Suite 122d Du Bois PA 15801-2440 |
| Mailing Address |
100 Hospital Ave Business Office Du Bois PA 15801-1440 |
| Practice Telephone | 8143754466 |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2015-07-22 |
| Authorized Official Name | BRIAN KLINE (CFO) |
| Authorized Official Telephone | 8143756377 |
| Is Organization Subpart | Y |
| Parent Organization Name | PENN HIGHLANDS HEALTHCARE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 100774088 | 05 |
| Other Name | Type Code |
|---|---|
| Penn Highlands DuBois | Doing Business As Name - Organization |
| Street Address |
90 BEAVER DR SUITE 122D |
| City | DU BOIS |
| State | PA |
| Zip Code | 15801-2440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710968995 | Jeffrey W Rice | Dentist | 90 Beaver Dr, Suite 101a, Du Bois, PA 15801-2440 | 2005-11-07 |
| 1609326362 | Brian M Elias Dpm PC | Non-Pharmacy Dispensing Site | 90 Beaver Dr, Building E, Du Bois, PA 15801-2440 | 2016-10-06 |
| 1063801397 | Pa Oral Facial & Implant Surgery | Dentist | 90 Beaver Dr, Suite 101a, Du Bois, PA 15801-2440 | 2015-01-09 |
| 1861763039 | Podiatry Associates of Dubois LLC | Podiatrist | 90 Beaver Dr, Building D, Du Bois, PA 15801-2440 | 2012-01-20 |
| 1710257795 | Moshannon Valley Psychiatric Services, PC | Nurse Practitioner | 90 Beaver Dr, Suite 210d, Du Bois, PA 15801-2440 | 2012-01-06 |
| 1821390717 | Jeffrey Ryan Rice | Surgery | 90 Beaver Dr, Suite 215 D, Du Bois, PA 15801-2440 | 2010-11-26 |
| 1437387628 | John Joseph Mocik | Social Worker | 90 Beaver Dr, Suite 117d, Du Bois, PA 15801-2440 | 2009-06-25 |
| 1033354550 | My Care Now, LLC | Family Medicine | 90 Beaver Dr, Building C, Du Bois, PA 15801-2440 | 2008-12-12 |
| 1013180918 | Breezewood Behavioral Health Services, Inc | Psychologist | 90 Beaver Dr, Ste 117d, Du Bois, PA 15801-2440 | 2008-04-11 |
| 1821209438 | Lisa A. Ferrill | Advanced Practice Midwife | 90 Beaver Dr, Ste 211d, Du Bois, PA 15801-2449 | 2007-05-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215551452 | Grace Polohonki | Counselor | 490 Jefers Street, Dubois, PA 15801 | 2020-06-03 |
| 1144869231 | Richard Lee Kerstetter II | Hearing Instrument Specialist | 124 San Juan Rd, Du Bois, PA 15801 | 2020-01-06 |
| 1700368487 | Holly Noel Knoll | Counselor | 490 Jeffers Street, Dubois, PA 15801 | 2018-08-30 |
| 1992298160 | Dubois Regional Medical Center | Family Medicine | 145 Hospital Ave Ste 315, Du Bois, PA 15801 | 2018-06-12 |
| 1154814846 | Sara Beth Stone | Dietitian, Registered | 16288 Treasure Lk, Du Bois, PA 15801 | 2018-06-07 |
| 1942790779 | Wendi Dawn Wenzel | Counselor | 490 Jeffers St., Dubois, PA 15801 | 2018-05-17 |
| 1144748443 | Nancy Foradora | Massage Therapist | 200 Narrows Creek Park Road, Dubois, PA 15801 | 2017-09-07 |
| 1679098891 | Deborah Jean Mitchell | Hearing Instrument Specialist | 900 Beaver Drive, Dubois, PA 15801 | 2017-08-09 |
| 1861937757 | Shaun M Kanouff | Counselor | 100 Caldwell Dr., Dubois, PA 15801 | 2016-12-30 |
| 1164897740 | Drayer Physical Therapy Institute LLC | Physical Therapist | 873 Beaver Drive, Dubois, PA 15801 | 2015-12-08 |
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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 |
|---|---|---|---|---|
| 1508046814 | Dubois Regional Medical Center | Dermatology | 145 Hospital Ave Ste 313, Du Bois, PA 15801-1465 | 2007-11-05 |
| 1609900604 | Richard E Johnson, Do, PC | Dermatology | 90 Beaver Dr, Ste 122-d, Du Bois, PA 15801-2440 | 2007-03-14 |
| 1588764906 | Dubois Regional Medical Center | Dermatology | 145 Hospital Ave Ste 313, Du Bois, PA 15801-1465 | 2006-09-25 |
| 1568447969 | Richard E Johnson | Dermatology | 90 Beaver Dr, Ste 122-d, Du Bois, PA 15801-2440 | 2005-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962013748 | Consonant Healing Medical Associates of Pa LLC | Dermatology | 49 Smith Mill Rd, New Freedom, PA 17349-8147 | 2020-08-13 |
| 1790395747 | Dermatology Specialists of Pennsylvania | Dermatology | 1122 Street Rd Ste 204, Southampton, PA 18966-4218 | 2020-08-05 |
| 1275151458 | Sylvan Dermatology LLC | Dermatology | 32 Parking Plz Ste 300, Ardmore, PA 19003-2443 | 2020-07-14 |
| 1841819455 | Rowe Dermatology, Pllc | Dermatology | 519 Owen Rd, Wynnewood, PA 19096-1714 | 2020-04-14 |
| 1750923579 | Alliance Dermatology Physicians, P.C. | Dermatology | 1205 Langhorne Newtown Road Suite 215, Langhorne, PA 19047 | 2019-10-14 |
| 1346882651 | Whalen Dermatology of Pittsburgh PC | Dermatology | 160 Millers Run Rd Ste 500, Bridgeville, PA 15017-1358 | 2019-10-09 |
| 1932740461 | Mark Abdelmalek, Md LLC | Dermatology | 200 N 16th St Ste D, Philadelphia, PA 19102-1225 | 2019-10-07 |
| 1093368185 | Alliance Dermatology Physicians, P.C. | Dermatology | 1205 Langhorne Newtown Rd Ste 215a, Langhorne, PA 19047-1219 | 2019-07-18 |
| 1821573619 | St. Luke's Physician Group, Inc | Dermatology | 1600 St Lukes Blvd Ste 100, Easton, PA 18045-5671 | 2018-09-27 |
| 1588147748 | Pittsburgh Skin PC | Dermatology | 144 Emeryville Dr Ste 230, Cranberry Twp, PA 16066-5015 | 2018-09-12 |
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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.