KRISTY LYNN CHATHAM (NPI# 1942294269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942294269 |
| Entity Type | Individual |
| Full Name | KRISTY LYNN CHATHAM |
| Credential | PAC |
| Practice Address |
525 N Dacie Pt Lecanto FL 34461-8399 |
| Practice Telephone | 3527462200 |
| Practice Fax Number | 3527469320 |
| Mailing Telephone | 3527462200 |
| Mailing Fax Number | 3527469320 |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2008-05-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | PA9102875 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | SRRGA | P00251111 | 01 |
| Street Address |
525 N DACIE PT |
| City | LECANTO |
| State | FL |
| Zip Code | 34461-8399 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336133792 | Michael Bruce Wartels | Dermatology | 525 N Dacie Pt, Lecanto, FL 34461-8399 | 2005-08-31 |
| 1447898150 | Nicole Schnell | Physician Assistant | 525 N Dacie Pt, Lecanto, FL 34461-8399 | 2019-12-12 |
| 1164075560 | Nancy Hindalong | Nurse Practitioner | 525 N Dacie Pt, Lecanto, FL 34461-8399 | 2019-07-24 |
| 1114461274 | Ashton Mae Wester | Nurse Practitioner | 525 N Dacie Pt, Lecanto, FL 34461-8399 | 2016-12-08 |
| 1366771115 | Carla Renee Bailey | Physician Assistant | 525 N Dacie Pt, Lecanto, FL 34461-8399 | 2009-12-08 |
| 1396794103 | Elizabeth M Estes | Nurse Practitioner | 525 N Dacie Pt, Lecanto, FL 34461-8399 | 2006-05-09 |
| 1043204365 | William Arch Welton IIi | Dermatology | 525 N Dacie Pt, Lecanto, FL 34461-8399 | 2005-09-01 |
| 1902890239 | Suncoast Dermatology and Skin Surgery Center, Pa | Dermatology | 525 N Dacie Pt, Lecanto, FL 34461-8399 | 2005-09-01 |
| 1073507455 | Margaret Anne Collins | Dermatology | 525 N Dacie Pt, Lecanto, FL 34461-8399 | 2005-08-31 |
| 1104810563 | Ralph Eugene Massullo Jr. | Dermatology | 525 N Dacie Pt, Lecanto, FL 34461-8399 | 2005-08-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891261160 | Shekinah Barfield | Physician Assistant | Pediatric and Internal Medicine Specialist Inc, 1990 N Prospect Ave, Lecanto, FL 34461 | 2018-10-15 |
| 1699240887 | Medical Risk Solutions | Family Medicine | 2804 W. Marc Knighton Court Key #10, Lecanto, FL 34461 | 2018-10-04 |
| 1851848097 | Pedim Outreach and Specialty Clinic LLC | Family Medicine | 1982 N Prospect Ave, Lecanto, FL 34461 | 2016-09-06 |
| 1265776579 | Wal-mart Stores East Lp | Technician/Technologist | 1936 N. Lecanto Hwy, Lecanto, FL 34461 | 2012-11-27 |
| 1922306109 | Pediatric and Internal Medicine Specialists, Pa | Clinic/Center | 1980 North Prospect Avenue, Lecanto, FL 34461 | 2011-03-11 |
| 1942459078 | Crq Enterprises LLC | Home Health | 4214 W Gulf To Lake Hwy, Lecanto, FL 34461 | 2008-09-12 |
| 1548418064 | Thomas Tybeck | Counselor | 324 S Kensington Ave Ste 328, Lecanto, FL 34461 | 2008-09-09 |
| 1356533566 | Amanda Nicole Coppedge | Optometrist | 240 N. Lecanto Hwy., Lecanto, FL 34461 | 2007-08-11 |
| 1679779185 | Brashears Vital Care Corp | Pharmacy | 471 N Dacie Pt, Lecanto, FL 34461 | 2007-06-22 |
| 1285751099 | Interim Healthcare Private Services, Inc. | Home Health | 581 E. Gulf To Lake Highway, Village West Plaza, Lecanto, FL 34461 | 2007-03-25 |
| Find all providers in zip 34461 | ||||
| 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 |
|---|---|---|---|---|
| 1336133792 | Michael Bruce Wartels | Dermatology | 525 N Dacie Pt, Lecanto, FL 34461-8399 | 2005-08-31 |
| 1043204365 | William Arch Welton IIi | Dermatology | 525 N Dacie Pt, Lecanto, FL 34461-8399 | 2005-09-01 |
| 1073507455 | Margaret Anne Collins | Dermatology | 525 N Dacie Pt, Lecanto, FL 34461-8399 | 2005-08-31 |
| 1104810563 | Ralph Eugene Massullo Jr. | Dermatology | 525 N Dacie Pt, Lecanto, FL 34461-8399 | 2005-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002154 | Precision Skin LLC | Dermatology | 3501 S University Dr Ste 5, Davie, FL 33328-2001 | 2020-10-28 |
| 1487252417 | Janice Reaume | Dermatology | 3335 Imperial Manor Way, Mulberry, FL 33860-5519 | 2020-10-12 |
| 1922617729 | Synergymd, LLC | Dermatology | 1208 E Kennedy Blvd Ste 221, Tampa, FL 33602-3509 | 2020-07-28 |
| 1518585447 | Alexander F Wong | Dermatology | 1300 Goodlette-frank Rd N, Naples, FL 34102-5243 | 2020-07-07 |
| 1508495003 | Elite Dermatology | Dermatology | 401 Coral Way Ste 207, Coral Gables, FL 33134-4924 | 2020-04-06 |
| 1124668371 | Meaghan Margaret Birakis | Dermatology | 3319 Fl-7 #202, Wellington, FL 33449 | 2020-01-15 |
| 1396380044 | Suzanne Marie Smith | Dermatology | 21097 Ne 27th Ct Ste 500, Miami, FL 33180-1235 | 2019-11-15 |
| 1376188383 | Enchantress Dermatology, Inc. | Dermatology | 241 Nw 119 Ave, Miami, FL 33182-1329 | 2019-11-13 |
| 1699319988 | Revivify Dermatology, LLC | Dermatology | 21301 Powerline Rd # 108, Boca Raton, FL 33433-2388 | 2019-10-30 |
| 1841833928 | Carly Marie Maher | Dermatology | 90 Cypress Way E Ste 50, Naples, FL 34110-9275 | 2019-10-22 |
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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.