WABASH VALLEY DERMATOLOGY AND MED SPA INC
NPI 1619561479
Nurse Practitioner - Family in Terre Haute, IN
About Wabash Valley Dermatology And Med Spa Inc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WABASH VALLEY DERMATOLOGY AND MED SPA INC (NPI 1619561479) is a healthcare organization registered as a family in Terre Haute, Indiana and active in the NPI registry since February 2021. The organization lists Lindsay Susan Wilson, President, 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)
Wabash Valley Dermatology And Med Spa Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Wabash Valley Dermatology And Med Spa Inc, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 Wabash Valley Dermatology And Med Spa Inc's NPI number?
The NPI number for Wabash Valley Dermatology And Med Spa Inc is 1619561479. It was assigned to this organization in the NPPES registry on February 23, 2021.
Where is Wabash Valley Dermatology And Med Spa Inc located?
Wabash Valley Dermatology And Med Spa Inc is located at 4949 E Poplar Dr, Terre Haute, IN 47803. The listed phone number is (217) 712-9512.
What is Wabash Valley Dermatology And Med Spa Inc's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Wabash Valley Dermatology And Med Spa Inc enrolled in Medicare?
Yes. Wabash Valley Dermatology And Med Spa Inc is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Wabash Valley Dermatology And Med Spa Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Wabash Valley Dermatology And Med Spa Inc. 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 Wabash Valley Dermatology And Med Spa Inc accept?
Health plans from Anthem Blue Cross and Blue Shield list Wabash Valley Dermatology And Med Spa Inc 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 Wabash Valley Dermatology And Med Spa Inc was last updated on February 23, 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.
# Wabash Valley Dermatology And Med Spa Inc · NPI 1619561479
Family organization in Terre Haute, Indiana. Organization record, active in the CMS NPPES registry since February 23, 2021.
## Identity
- **NPI:** 1619561479 (Entity type: Organization)
- **Enumerated:** February 23, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Lindsay Wilson, PRESIDENT
## Practice location
- **Address:** 4949 E POPLAR DR, Terre Haute, IN 47803-2434
- **Phone:** (217) 712-9512
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 23, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1619561479) · Data from the CMS NPPES public registry.