CAROLINA DERMATOLOGY GRP (NPI# 1083693857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083693857 |
| Entity Type | Organization |
| Organization Name | CAROLINA DERMATOLOGY GRP |
| Practice Address |
1706 St Julians Place Columbia SC 29204-2410 |
| Practice Telephone | 8037717506 |
| Practice Fax Number | 8037719455 |
| Mailing Telephone | 8037717506 |
| Mailing Fax Number | 8037719455 |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2011-08-30 |
| Authorized Official Name | DR. MARK G BLASKIS (PRESIDENT) |
| Authorized Official Telephone | 8037717506 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
SC | Allopathic & Osteopathic Physicians | |
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP1028 | 05 |
| Street Address |
1706 ST JULIANS PLACE |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29204-2410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992215149 | Ricardo Colon II | Registered Nurse | 3000 Hampton Street, Columbia, SC 29204 | 2017-10-02 |
| 1780113522 | Carla Star Noe | Registered Nurse | Sc Department of Health and Environmental Control, 2100 Bull Street, Collumbia, SC 29204 | 2017-06-06 |
| 1124568514 | Kristy L Thompson | Nurse Practitioner | 1655 Bernardin Ave Ste 240, Columbia, SC 29204 | 2017-03-03 |
| 1982052031 | Harold Eugene Cook Iv | Podiatrist | 1730 St Julian Place, Columbia, SC 29204 | 2016-05-31 |
| 1851748974 | Shaquita Banks | Counselor | 1810 Allen Benedict Ct, A1, Columbia, SC 29204 | 2016-05-18 |
| 1265804835 | Premier Care, LLC | Case Management | 2712 Middleburg Drive, Suite 206, Columbia, SC 29204 | 2015-10-22 |
| 1023492287 | Shamiquia N. Mcpherson | Counselor | 1627 Auburn St., Columbia, SC 29204 | 2015-07-16 |
| 1285028449 | The Columbia Free Medical Clinic, Inc. | Clinic/Center | 1875 Harden Street, Columbia, SC 29204 | 2015-03-26 |
| 1629473459 | Leslie Wilson | Counselor | 2323 Lady Street, Columbia, SC 29204 | 2014-10-22 |
| 1053728683 | Candyce Sutton | Social Worker | 1135 Carter Street, Columbia, SC 29204 | 2014-07-15 |
| Find all providers in zip 29204 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528537057 | Cayce Medical Spa, Inc | Dermatology | 2001 Corona Rd Ste 201, Columbia, MO 65203-5924 | 2018-11-14 |
| 1366946832 | Novahealth Medical Group, LLC | Dermatology | 3208 Lemone Industrial Blvd Ste A, Columbia, MO 65201-8244 | 2018-03-20 |
| 1508248576 | Kaitlin Ann Schiavo | Dermatology | 204 N Keene St Ste 100, Columbia, MO 65201-8136 | 2015-06-25 |
| 1588041289 | Megan Casady | Dermatology | 10710 Charter Dr Ste 420, Columbia, MD 21044-3276 | 2015-05-01 |
| 1104239037 | Ashley Miles Jenkins | Dermatology | 1000 W Nifong Blvd Ste 150, Columbia, MO 65203-5615 | 2014-06-09 |
| 1497000723 | Leslie Brooke Mills | Dermatology | 2011 Corona Rd Ste 207, Columbia, MO 65203-2548 | 2012-07-24 |
| 1225397458 | Wynn Kao Dermatology, LLC | Dermatology | 10705 Charter Dr Ste 330, Columbia, MD 21044-2885 | 2012-05-08 |
| 1073811253 | Edward Shmunes | Dermatology | 3701 Northshore Rd, Columbia, SC 29206-3365 | 2011-03-11 |
| 1316178346 | M.r. Taylor Rayburn, Jr. M.d. P.C. | Dermatology | 1411 Hatcher Ln, Columbia, TN 38401-3535 | 2009-08-08 |
| 1518193630 | Chesahna Kindred | Dermatology | 8900 Columbia 100 Pkwy Ste F, Columbia, MD 21045-2336 | 2009-06-03 |
| Find all providers in COLUMBIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.