THE GALLERY
NPI 1205408630
Dermatology in Lake Charles, LA

Active since July 14, 2021
1936 SOUTHWOOD DR, LAKE CHARLES, LA 70605(337) 564-7546 Get Directions Write a Review

NPPES record last updated: July 14, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About The Gallery NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THE GALLERY (NPI 1205408630) is a healthcare organization registered as a dermatology in Lake Charles, Louisiana and active in the NPI registry since July 2021. The organization lists Kerri Elizabeth Davis-fontenot, Owner, as its authorized official.

NPPES Registry Identity

NPI1205408630
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameTHE GALLERY OF DERMATOLOGY AND ADVANCED AESTHETICS
Location Address1936 SOUTHWOOD DRLake Charles, LA 70605-4131
Mailing Address1936 Southwood DrLake Charles, LA 70605-4131 · (337) 564-7546
Organization SubpartNo
Authorized OfficialKerri Elizabeth Davis-fontenotOwner · (337) 564-7546
Enumeration DateJuly 14, 2021
NPPES CertifiedJuly 14, 2021
✔ NPI 1205408630 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
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.
1936 SOUTHWOOD DR, Lake Charles, LA 70605

Other Names 1

Doing Business AsThe Gallery

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

The Gallery is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by October 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateLouisianaEnrollment IDO20211013002237Non-DME Part B · Clinic/Group PracticeDue dateOctober 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to The Gallery, which bills Medicare for the services this clinician delivers.

Clinician (1)

Dermatology
NPI 1932528080
2000 TYBEE LN
Lake Charles, LA 70605
(337) 433-7272
✔ PECOS✔ Accepts Medicare0.2 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is The Gallery Of Dermatology And Advanced Aesthetics's NPI number?

The NPI number for The Gallery Of Dermatology And Advanced Aesthetics is 1205408630. It was assigned to this organization in the NPPES registry on July 14, 2021. The provider is doing business as The Gallery.

Where is The Gallery Of Dermatology And Advanced Aesthetics located?

The Gallery Of Dermatology And Advanced Aesthetics is located at 1936 Southwood Dr, Lake Charles, LA 70605. The listed phone number is (337) 564-7546.

What is The Gallery Of Dermatology And Advanced Aesthetics's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is The Gallery Of Dermatology And Advanced Aesthetics enrolled in Medicare?

Yes. The Gallery Of Dermatology And Advanced Aesthetics is registered in the Medicare PECOS enrollment system.

When is The Gallery Of Dermatology And Advanced Aesthetics's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Louisiana, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through The Gallery Of Dermatology And Advanced Aesthetics?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to The Gallery Of Dermatology And Advanced Aesthetics. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does The Gallery Of Dermatology And Advanced Aesthetics accept?

Health plans from Blue Cross and Blue Shield of Louisiana and HMO Louisiana list The Gallery Of Dermatology And Advanced Aesthetics as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for The Gallery Of Dermatology And Advanced Aesthetics was last updated on July 14, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.