Renew Family Dermatology LLC
NPI 1275198913ActiveOrganization· Dermatology· Fort Payne, AL
Dermatology in Fort Payne, Alabama, registered in NPPES in May 2019. The authorized official on file is Pam Mason, Manager. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1275198913 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 8, 2019 |
| Last updated in NPPES | Mar 5, 2026 |
| Certified by provider | Mar 5, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
| Clinic/Center, Medical Specialty | 261QM2500X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (AL) |
|---|
Other Dermatology providers in Fort Payne
- 1871758938