DERMATOLOGY CENTER OF HICKORY, PA (NPI# 1518278902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518278902 |
| Entity Type | Organization |
| Organization Name | DERMATOLOGY CENTER OF HICKORY, PA |
| Practice Address |
245 11th Ave Ne Hickory NC 28601-3885 |
| Practice Telephone | 8283283500 |
| Practice Fax Number | 8283288777 |
| Mailing Telephone | 8283283500 |
| Mailing Fax Number | 8283288777 |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2011-07-05 |
| Authorized Official Name | DR. JERRY LEE PRUITT (PRESIDENT) |
| Authorized Official Telephone | 8283283500 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | RR MEDICARE | 070015170 | 01 |
| NC | BLUE CROSS BLUE SHIELD OF NORTH CAROLINA | 69390 | 01 |
| Street Address |
245 11TH AVE NE |
| City | HICKORY |
| State | NC |
| Zip Code | 28601-3885 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124078274 | Jerry L Pruitt | Dermatology | 245 11th Ave Ne, Hickory, NC 28601-3835 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555236 | Mathew Ryan Dunn | Specialist/Technologist | 755 5th St Ne, Hickory, NC 28601 | 2020-10-14 |
| 1669086757 | Alex Neil Hines | Massage Therapist | 2759 North Center Street, Hickory, NC 28601 | 2020-09-04 |
| 1306327515 | Natasha Anderson | Nurse Practitioner | 2830 16th St Ne Apt 94, Hickory, NC 28601 | 2018-08-25 |
| 1902382120 | Danielle Marie Cisney | Counselor | 1219 10th Street Blvd Nw Apt F, Hickory, NC 28601 | 2018-07-11 |
| 1295243681 | Maggie Isabelle Mccarrick | Specialist/Technologist | 2225 6th St Nw, Hickory, NC 28601 | 2018-01-19 |
| 1487165395 | Healthstat Onsite Clinic Hsm Metal | Preventive Medicine | 180 Mcdonald Parkway Sw, Hickory, NC 28601 | 2017-10-18 |
| 1407249691 | Alexcia Dawn Pennell | Registered Nurse | 1501 Tate Blvd Sw, Suite 201, Hickory, NC 28601 | 2015-03-11 |
| 1134527484 | Pamilla Griffin Yount | Specialist | 825 3rd Ave. Nw, Hickory, NC 28601 | 2014-12-18 |
| 1831593615 | Josephine Lovelace Polhemus | Pharmacist | 12th Avenue Ne, Hickory, NC 28601 | 2014-10-22 |
| 1275957128 | Amy Lor | Acupuncturist | 46 Cloninger Mill Rd Ne Ste E, Hickory, NC 28601 | 2014-02-13 |
| Find all providers in zip 28601 | ||||
| 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 |
|---|---|---|---|---|
| 1386934933 | Jake Everett Turrentine | Dermatology | 1899 Tate Blvd Se Ste 2110, Hickory, NC 28602-4200 | 2011-04-17 |
| 1124078274 | Jerry L Pruitt | Dermatology | 245 11th Ave Ne, Hickory, NC 28601-3835 | 2006-05-11 |
| 1982693842 | Charles Nathan Reed | Dermatology | 1870 N Center St, Hickory, NC 28601-1853 | 2005-10-13 |
| 1770585788 | Dori L Hunt | Dermatology | 1927 3rd Avenue Ln Se, Hickory, NC 28602-2960 | 2005-08-10 |
| 1265768485 | George Dimitri Magel | Dermatology | 315 19th St Se, Hickory, NC 28602-4230 | 2009-10-22 |
| 1295845386 | Richard J. Salomon, M.d. | Dermatology | 1985 Tate Blvd Se, Hickory, NC 28602-1433 | 2006-08-30 |
| 1326151010 | Reed Dermatology Clinic Pa | Dermatology | 1870 N Center St, Hickory, NC 28601-1853 | 2006-08-16 |
| 1265452023 | Bethany Bergamo | Dermatology | 1927 3rd Avenue Ln Se, Hickory, NC 28602-2960 | 2006-07-21 |
| 1639132814 | Karen Trygg Wold | Dermatology | 1985 Tate Blvd Se, Hickory, NC 28602-1433 | 2006-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811128 | Foothills Family Dermatology | Dermatology | 118 North Sterling St, Morganton, NC 28655 | 2020-11-04 |
| 1316556871 | Easterm Dermatology, Pa | Dermatology | 1840 Nc Hwy 24, Newport, NC 28570 | 2020-07-30 |
| 1548878549 | Clara Dermatology | Dermatology | 7250 O'kelly Chapel Road, Suite 100, Cary, NC 27519 | 2020-07-16 |
| 1841837507 | Southeast Vulvar Clinic, Pllc | Dermatology | 6406 Carmel Road, Suite 309, Charlotte, NC 28226 | 2019-12-02 |
| 1205481009 | Novant Medical Group Inc | Dermatology | 6324 Fairview Rd # 200, Charlotte, NC 28210-3271 | 2019-08-08 |
| 1073172433 | Elaine Otchere | Dermatology | M145 Green Zone Duke South 40 Duke Medicine Circle, Durham, NC 27710-8267 | 2019-06-10 |
| 1902469570 | Falling Leaves Dermatology Mooresville LLC | Dermatology | 136 Corporate Park Dr Ste H, Mooresville, NC 28117-6960 | 2019-04-18 |
| 1669945259 | Claire Engel Holmquist | Dermatology | 11301 Golf Links Dr N Ste 203, Charlotte, NC 28277-8014 | 2019-01-07 |
| 1497227144 | Integrated Dermatology of North Carolina, Pllc | Dermatology | 10512 Park Rd Ste 113, Charlotte, NC 28210-8469 | 2018-12-19 |
| 1558848093 | Dermatology Consultants of Asheville Pllc | Dermatology | 218 Elkwood Ave # 104, Woodfin, NC 28804-2247 | 2018-07-27 |
| 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.