NORTHEAST DERMATOLOGY, PA (NPI# 1154422558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154422558 |
| Entity Type | Organization |
| Organization Name | NORTHEAST DERMATOLOGY, PA |
| Practice Address |
220 Graces Way Columbia SC 29229 |
| Practice Telephone | 8037364560 |
| Practice Fax Number | 8037441217 |
| Mailing Telephone | 8037364560 |
| Mailing Fax Number | 8037441217 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2009-10-08 |
| Authorized Official Name | DR. LEE SMITH CARSON (PRESIDENT) |
| Authorized Official Telephone | 8037364560 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 22975 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | DEA | BC 7575939 | 01 |
| Street Address |
220 GRACES WAY |
| City | COLUMBIA |
| State | SC |
| Zip Code | 29229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649248576 | Lee Smith Carson | Dermatology | 220 Graces Way, Columbia, SC 29229-1613 | 2006-03-08 |
| 1013430420 | Taylor C Dieter | Surgery | 220 Graces Way, Columbia, SC 29229-1613 | 2017-07-18 |
| 1386084655 | Jessica Faye Hall | Physician Assistant | 220 Graces Way, Columbia, SC 29229-1613 | 2013-07-01 |
| 1821432899 | Devon Elizabeth Driver | Nurse Practitioner | 220 Graces Way, Columbia, SC 29229-1613 | 2013-04-22 |
| 1477784833 | Carrie Powers Zipperer | Physician Assistant | 220 Graces Way, Columbia, SC 29229-1613 | 2009-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194332619 | Candid South Carolina, P.C. | Dentist | 136-4 Forum Drive #a20, Columbia, SC 29229 | 2020-09-29 |
| 1275166761 | Isis Marie Pearson | Behavior Technician | 4611 Hardscrabble Rd, #239, Columbia, SC 29229 | 2020-02-13 |
| 1083254338 | Lintiya Mccleary | Behavior Technician | 1048 Wildewood Center Dr, Columbia, SC 29229 | 2020-01-14 |
| 1538702873 | Genuine Care LLC | Home Health Aide | 112 Denby Cir, Columbia, SC 29229 | 2019-10-18 |
| 1588218028 | John Calvin Thorne Iv | Pharmacist | 175 Forum Drive, Columbia, SC 29229 | 2019-08-01 |
| 1801303839 | Eye Associates of Columbia Inc | Clinic/Center | 470-5 Town Center Pl, Lenscrafters, Columbia, SC 29229 | 2017-12-28 |
| 1508385469 | Palmetto Community Group | Counselor | 402 Nautique Circle, Columbia, SC 29229 | 2017-09-12 |
| 1245754472 | Fernandez Interpreter & Translator Solutions | Interpreter | 140 Rivendale Drive, Columbia, SC 29229 | 2017-07-30 |
| 1770935744 | Yasmine Gamil Gabr | Family Medicine | 103 Summit Centre Drive, Columbia, SC 29229 | 2016-07-01 |
| 1386095164 | Mack's Loving Care | Home Health | 55 Crooked Creek Place, Columbia, SC 29229 | 2016-06-23 |
| Find all providers in zip 29229 | ||||
| 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.