Craig D Omohundro (NPI# 1457346850, PAC ID# 4688653868) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1457346850 |
| PAC ID by PECOS | 4688653868 |
| Professional Enrollment ID | I20100712000379 |
| Full Name | Craig D Omohundro |
| Organization Legal Name | AFFILIATED DERMATOLOGY, PC |
| Address |
4300 W Main St Suite 102 Dothan AL 36305-1051 |
| Phone Number | 3347939564 |
| Gender | M |
| Medical School | UNIVERSITY OF CALIFORNIA, SAN FRANCISCO SCHOOL OF MEDICINE |
| Graduation Year | 1993 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 2163401332 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 010055 | FLOWERS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 4300 W Main St, Suite 102, Dothan, AL 36305-1051 | 3347939564 | AFFILIATED DERMATOLOGY, PC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| MIPS_EC_137_overall | Melanoma: Continuity of Care - Recall System | 100% | |
| MIPS_EC_224_overall | Melanoma: Overutilization of Imaging Studies in Melanoma | 100% | |
| MIPS_EC_238_2+ | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 0% | |
| MIPS_EC_238_overall | Use of High-Risk Medications in the Elderly (100%: worst, 0% best) | 0% | |
| MIPS_EC_265_overall | Biopsy Follow-Up | 100% | |
| MIPS_EC_402_overall | Tobacco Use and Help with Quitting Among Adolescents | 100% |
| Organization Legal Name | AFFILIATED DERMATOLOGY, PC |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Norma Faye Mcknight | Nurse Practitioner | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Kelli N Heer | Physician Assistant | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Tonia L Ruddock | Dermatology | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Laura M Tamburin | Dermatology | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Dana L Culpepper | Physician Assistant | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Robert B Ash | Dermatology | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Street Address |
4300 W MAIN ST SUITE 102 |
| City | DOTHAN |
| State | AL |
| Zip | 36305-1051 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Parks W Pratt Iii | Rheumatology | 4300 W Main St, Suite 102, Dothan, AL 36305-1306 | |
| Samantha P Carter | Nurse Practitioner | Wiregrass Clinic LLC | 4300 W Main St, Suite 16, Dothan, AL 36305-1310 |
| Chelsey Jane Smith | Otolaryngology | Dothan Ent Associates, P.C. | 4300 W Main St, Suite 403, Dothan, AL 36305-4001 |
| Emily E Cannon | General Surgery | Wiregrass Surgical Associates, P.C. | 4300 W Main St, Suite 24, Dothan, AL 36305-1312 |
| Paul C Motta | Allergy/immunology | Dothan Ent Associates, P.C. | 4300 W Main St, Suite 403, Dothan, AL 36305-4001 |
| Bradley T Marker | General Surgery | Wiregrass Surgical Associates, P.C. | 4300 W Main St, Suite 24, Dothan, AL 36305-1312 |
| Norma Faye Mcknight | Nurse Practitioner | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Kelli N Heer | Physician Assistant | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Roger J Williams | Urology | Wiregrass Urology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1306 |
| Jason Lee Cox | Nurse Practitioner | Wiregrass Clinic LLC | 4300 W Main St, Suite 21, Dothan, AL 36305-1058 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert M Hagler | Obstetrics/gynecology | Womens Healthcare of Dothan PC | Suite, 31 4300 W Main St, Dothan, AL 36305-1051 |
| Tonia L Ruddock | Dermatology | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Laura M Tamburin | Dermatology | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Candace N Short | Nurse Practitioner | Womens Healthcare of Dothan PC | Suite, 31 4300 W Main St, Dothan, AL 36305-1051 |
| James Butler | Obstetrics/gynecology | Womens Healthcare of Dothan PC | Suite, 31 4300 W Main St, Dothan, AL 36305-1051 |
| Philip Mathew Dozier | Obstetrics/gynecology | Womens Healthcare of Dothan PC | Suite, 31 4300 W Main St, Dothan, AL 36305-1051 |
| Christopher E Nicholls | Obstetrics/gynecology | Womens Healthcare of Dothan PC | Suite, 31 4300 W Main St, Dothan, AL 36305-1051 |
| Deborah M Helms | Physician Assistant | Womens Healthcare of Dothan PC | Suite, 31 4300 W Main St, Dothan, AL 36305-1051 |
| Bryan C Mullins | Obstetrics/gynecology | Womens Healthcare of Dothan PC | Suite, 31 4300 W Main St, Dothan, AL 36305-1051 |
| Dana L Culpepper | Physician Assistant | Affiliated Dermatology, PC | 4300 W Main St, Suite 102, Dothan, AL 36305-1051 |
| Find all physicians in zip 36305 | |||
| City | DOTHAN |
| Zip Code | 36305 |
| Specialty | DERMATOLOGY |
| City + Specialty | DOTHAN + DERMATOLOGY |
Please comment or provide details below to improve the information on Craig D Omohundro.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.