STATE WIDE DERMATOLOGY LLC
NPI 1427473073
Dermatology in Odessa, FL
About State Wide Dermatology Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
STATE WIDE DERMATOLOGY LLC (NPI 1427473073) is a healthcare organization registered as a dermatology in Odessa, Florida and active in the NPI registry since February 2014. The organization lists Kathleen Y Harrell, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
State Wide Dermatology Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to State Wide Dermatology LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.
Clinicians, nearest first (5)
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 State Wide Dermatology LLC's NPI number?
The NPI number for State Wide Dermatology LLC is 1427473073. It was assigned to this organization in the NPPES registry on February 19, 2014.
Where is State Wide Dermatology LLC located?
State Wide Dermatology LLC is located at 17121 Rainbow Ter, Odessa, FL 33556. The listed phone number is (813) 749-6907.
What is State Wide Dermatology LLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is State Wide Dermatology LLC enrolled in Medicare?
Yes. State Wide Dermatology LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through State Wide Dermatology LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians, all in Nurse Practitioner, reassign their Medicare billing to State Wide Dermatology LLC. 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. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does State Wide Dermatology LLC accept?
Health plans from AmeriHealth Caritas Next list State Wide Dermatology LLC 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 State Wide Dermatology LLC was last updated on July 28, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.