KINSTON DERMATOLOGY, PA (NPI# 1508976432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508976432 |
| Entity Type | Organization |
| Organization Name | KINSTON DERMATOLOGY, PA |
| Practice Address |
701 Doctors Dr Kinston Clinic North, Suite F Kinston NC 28501-1584 |
| Practice Telephone | 2525233289 |
| Practice Fax Number | 2525231310 |
| Mailing Telephone | 2525233289 |
| Mailing Fax Number | 2525231310 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. DIANA MONROE HENSHAW (SECRETARY/TREASURER) |
| Authorized Official Telephone | 2525233289 |
| Authorized Official Credential | EDD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 84026 | NC | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 0105H | 01 | |
| NC | 790105H | 05 |
| Street Address |
701 DOCTORS DR KINSTON CLINIC NORTH, SUITE F |
| City | KINSTON |
| State | NC |
| Zip Code | 28501-1584 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407852353 | Mark D Marilley | Internal Medicine | 701 Doctors Dr, Suite N, Kinston, NC 28501-1584 | 2005-06-24 |
| 1740716059 | Carolina Orthopedic and Sports Medicine, Inc - Kinston | Orthopaedic Surgery | 701 Doctors Dr, Suite N, Kinston, NC 28501-1589 | 2017-05-05 |
| 1366895880 | Lenoir Physicians Network, LLC | Obstetrics & Gynecology | 701 Doctors Dr, Suite E1, Kinston, NC 28501-1589 | 2016-07-20 |
| 1720447386 | Owen Davis | Physician Assistant | 701 Doctors Dr, Suite G, Kinston, NC 28501-1589 | 2016-02-11 |
| 1104220300 | Lenoir Physicians Network LLC | Psychiatry & Neurology | 701 Doctors Dr, Suite E2, Kinston, NC 28501-1589 | 2014-10-16 |
| 1871993063 | Lenoir Physicians Network LLC | Urology | 701 Doctors Dr, Suite L, Kinston, NC 28501-1589 | 2014-08-26 |
| 1407269426 | Victoria Conway | Nurse Practitioner | 701 Doctors Dr, Suite N, Kinston, NC 28501-1589 | 2014-06-06 |
| 1962823039 | Dempsey's Long Term Care, LLC | Pharmacy | 701 Doctors Dr, Suite P-2, Kinston, NC 28501-1589 | 2013-12-17 |
| 1376980482 | Mallory Conway Tucker | Nurse Practitioner | 701 Doctors Dr, Suite N, Kinston, NC 28501-1589 | 2013-05-30 |
| 1639414915 | Kinston Clinic Pharmacy | Pharmacy | 701 Doctors Dr, Suite P, Kinston, NC 28501-1589 | 2012-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912428780 | Latasha Carr | Counselor | 120 Lenoir Str, B, Kinston, NC 28501 | 2017-07-03 |
| 1598295107 | Craig A Marva | Dentist | 1104 West Vernon Ave., Kinston, NC 28501 | 2017-06-15 |
| 1235535238 | Rachel Krueger | Pharmacist | 201 West Vernon Ave, Kinston, NC 28501 | 2014-11-18 |
| 1457773020 | Abigail L Hemmings | Physician Assistant | 2509 North Queen Street, Kinston, NC 28501 | 2014-01-15 |
| 1730521063 | Courtney Mitchell Iv | Dentist | 2500 N Herritage St., Suite A, Kinston, NC 28501 | 2013-07-29 |
| 1023459757 | Courtney Mitchell, IIi Dds Pa | Dentist | 2500 N. Herritage St., Suite A, Kinsten, NC 28501 | 2013-07-10 |
| 1558609602 | Jessica Meria Hendricks | Counselor | 400 Glenwood Ave Ste 2, Kinston, NC 28501 | 2013-01-24 |
| 1871853523 | Bethany Mckittrick Griffin | Pharmacist | 300 North Queen Street, Kinston, NC 28501 | 2012-05-29 |
| 1750647574 | Peter K Hobler | Counselor | 2902 N. Heritage Street, Kinston, NC 28501 | 2012-04-05 |
| 1568732154 | Michael Dion Smallwood | Counselor | 2902 A North Heritage St, Kinston, NC 28501 | 2012-01-12 |
| Find all providers in zip 28501 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376712802 | Wayne T. Jarman, Md Pa | Specialist | 703d Rosanne Dr, Kinston, NC 28504-1551 | 2008-02-28 |
| 1679767750 | Rudolph I Mintz Jr | Specialist | 400 Glenwood Ave, Suite 11, Kinston, NC 28501-3851 | 2007-08-31 |
| 1336273606 | Linda S Cole | Specialist | 2508 N Queen St, Kinston, NC 28501-1631 | 2007-03-16 |
| 1679507651 | Ramesh Mutyala | Specialist | 100 Airport Rd, Kinston, NC 28501-1604 | 2006-07-10 |
| 1316902836 | Kinston Urological Associates, Pa | Specialist | 701 Doctors Dr, Suite L, Kinston, NC 28501-1584 | 2006-04-18 |
| 1790752897 | Dr. Saracino Gastroenterolgy, P.C. | Specialist | 2602 N Herritage St, Kinston, NC 28501-1503 | 2006-03-07 |
| 1891772695 | Ralph Lee Cox | Specialist | 701 Doctors Dr, Suite L, Kinston, NC 28501-1589 | 2005-12-22 |
| 1669459475 | Richard Martin Hughes | Specialist | 701 Doctors Dr, Suite L, Kinston, NC 28501-1589 | 2005-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989812 | Ryan Graham | Specialist | 405 Avett Dr, Durham, NC 27703-8291 | 2020-07-14 |
| 1184248197 | Tunishia Chanel Parks | Specialist | 106 Daniels Ave, Battleboro, NC 27809-7503 | 2020-06-05 |
| 1306460811 | Ashley Davis | Specialist | 765 Highland Oaks Dr Ste 100, Winston Salem, NC 27103-7100 | 2020-06-01 |
| 1083236996 | Latisha Isheema Buchanan | Specialist | 3215 Guess Rd Ste 101, Durham, NC 27705-2668 | 2020-05-13 |
| 1356962872 | Katherine Joy Griffin | Specialist | 1112 Bottle Brush Ln, Harrisburg, NC 28075-6716 | 2020-05-06 |
| 1174158315 | Shanese Spaulding | Specialist | 309 N Elm St, Lumberton, NC 28358-5649 | 2020-03-09 |
| 1417590290 | Sarah Lyn Granahan | Specialist | 107 Windel Dr Ste 205, Raleigh, NC 27609-4471 | 2019-10-23 |
| 1215580949 | Felisha Cheadle | Specialist | 240 Appalachian Dr, Raeford, NC 28376-6342 | 2019-07-22 |
| 1962062240 | Shenika Twanet Judd | Specialist | 724 N Reilly Rd Ste C, Fayetteville, NC 28303-6042 | 2019-06-18 |
| 1033676358 | Suzanne Lynn Washburn | Specialist | 307 Barcelona Drive 26e, Fayetteville, NC 28303-5768 | 2019-02-22 |
| Find all providers with the same taxonomy | ||||
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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.