CENTRAL CAROLINA DERMATOLOGY CLINIC (NPI# 1316943145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316943145 |
| Entity Type | Organization |
| Organization Name | CENTRAL CAROLINA DERMATOLOGY CLINIC |
| Practice Address |
404 Westwood Ave Ste 107 High Point NC 27262-4316 |
| Practice Telephone | 3368873195 |
| Practice Fax Number | 3368873194 |
| Mailing Telephone | 3368873195 |
| Mailing Fax Number | 3368873194 |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2014-09-08 |
| Authorized Official Name | SAMUEL CRAIG KIRBY (PRESIDENT) |
| Authorized Official Telephone | 3368873195 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NI0002X |
Dermatology Specialization: Clinical & Laboratory Dermatological Immunology |
34D0238143 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8901788 | 05 | |
| NC | MEDICARE GROUP NUMBER | 230129 | 01 |
| NC | RAILROAD MEDICARE | CD4358 | 01 |
| Street Address |
404 WESTWOOD AVE STE 107 |
| City | HIGH POINT |
| State | NC |
| Zip Code | 27262-4316 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659375160 | Robert Tad Migliardi | Dermatology | 404 Westwood Ave, Ste 107, High Point, NC 27262-4316 | 2005-06-13 |
| 1043834500 | Helen Andraos | Physician Assistant | 404 Westwood Ave, High Point, NC 27262-4315 | 2020-06-01 |
| 1174046387 | Ginny Vanderburg | Physician Assistant | 404 Westwood Ave, High Point, NC 27262-4315 | 2017-07-19 |
| 1699123836 | Regional Physicians LLC | Internal Medicine | 404 Westwood Ave, Ste. 207, High Point, NC 27262 | 2016-05-27 |
| 1669836300 | Henry Calvin Martensen IIi | Physician Assistant | 404 Westwood Ave, Suite 303, High Point, NC 27262-4315 | 2016-04-08 |
| 1952738346 | Regional Physicians LLC | Surgery | 404 Westwood Ave, Ste.205, High Point, NC 27262-4315 | 2013-10-01 |
| 1235405275 | Kirsten N Martine-schrader | Specialist/Technologist | 404 Westwood Ave, Suite 205, High Point, NC 27262-4315 | 2012-03-23 |
| 1447537535 | High Point Regional Health System | Neurological Surgery | 404 Westwood Ave, Suite 201, High Point, NC 27262-4315 | 2011-11-03 |
| 1518285980 | Regional Physicians LLC | Specialist | 404 Westwood Ave, Ste. 205, High Point, NC 27262 | 2010-05-11 |
| 1043403637 | Keith Bryan Cottle | Counselor | 404 Westwood Ave, Suite 207, High Point, NC 27262-4315 | 2007-08-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821623620 | Lane and Associates Xxxviii Dds Pa | Dentist | 101 Northpoint Avenue, High Point, NC 27262 | 2020-03-12 |
| 1043869936 | Norma Mechelle Cox | Technician | 1145 Hawick Dr, High Point, NC 27262 | 2019-09-04 |
| 1417514910 | Jennifer A. Loveland Dmd II Pllc | Dentist | 1007 Phillips Avenue, Suite 103, High Point, NC 27262 | 2019-05-21 |
| 1982175196 | World Relief Corp of National Association of Evangelicals | Marriage & Family Therapist | 155 Northpoint Avenue, Suite 102, High Point, NC 27262 | 2018-12-16 |
| 1538679907 | Zackary Daniel Rogers | Physician Assistant | 1814 Westchester Dr #301, High Point, NC 27262 | 2017-10-11 |
| 1184164162 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2005 N Main St., Suite 101, High Point, NC 27262 | 2017-02-24 |
| 1225483951 | Randall Godette | Physician Assistant | 611 Lindsay Street, High Point, NC 27262 | 2016-05-02 |
| 1336537356 | Optics, Inc. | Durable Medical Equipment & Medical Supplies | 1105 Lindsay Street, High Point, NC 27262 | 2014-12-29 |
| 1871902346 | Isha Bangura | Counselor | 910 Mill Ave., High Point, NC 27262 | 2014-08-08 |
| 1831478833 | Jenny Susan Mason | Specialist/Technologist | 922 West College Dr, High Point, NC 27262 | 2011-08-08 |
| Find all providers in zip 27262 | ||||
| Taxonomy Code | 207NI0002X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Clinical & Laboratory Dermatological Immunology |
| A dermatologist who utilizes various specialized laboratory procedures to diagnose disorders characterized by defective responses of the body's immune system. Immunodermatologists also may provide consultation in the management of these disorders and administer specialized forms of therapy for these diseases. |
| 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 |
|---|---|---|---|---|
| 1033459011 | Dermatology Associates of Coastal Carolina | Dermatology | 39a Office Park Dr, Jacksonville, NC 28546-3220 | 2013-02-27 |
| 1396270468 | Sona Medspa Physician Group, Pllc | Dermatology | 7825 Ballantyne Commons Pkwy, Suite 300, Charlotte, NC 28277-3174 | 2017-04-26 |
| 1023358231 | Dermatology Associates of Coastal Carolina | Dermatology | 3332 Bridges St, Suite B, Morehead City, NC 28557-3280 | 2013-02-25 |
| 1467497313 | John David Ausum | Dermatology | 1100 Tunnel Rd, Vamc Med Service, Asheville, NC 28805-2043 | 2006-06-17 |
| City | HIGH POINT |
| Zip Code | 27262 |
Please comment or provide details below to improve the information on CENTRAL CAROLINA DERMATOLOGY CLINIC.
| 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.