FLYNN DERMATOLOGY PA (NPI# 1588674568) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588674568 |
| Entity Type | Organization |
| Organization Name | FLYNN DERMATOLOGY PA |
| Other Organization Name | FAMILY DERMATOLOGY |
| Practice Address |
5603 Duraleigh Rd Suite 111 Raleigh NC 27612-2688 |
| Practice Telephone | 9197910840 |
| Practice Fax Number | 9197910911 |
| Mailing Telephone | 9197910840 |
| Mailing Fax Number | 9197910911 |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2007-08-24 |
| Authorized Official Name | MATTHEW K FLYNN (PRESIDENT) |
| Authorized Official Telephone | 9197910840 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | NC | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Family Dermatology | Doing Business As Name - Organization |
| Street Address |
5603 DURALEIGH RD SUITE 111 |
| City | RALEIGH |
| State | NC |
| Zip Code | 27612-2688 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689678336 | Matthew K Flynn | Specialist | 5603 Duraleigh Rd, Ste 111, Raleigh, NC 27612-2688 | 2005-06-10 |
| 1548529001 | Kara Mariko Brooks | Dermatology | 5603 Duraleigh Rd, Suite 111, Raleigh, NC 27612-2688 | 2012-05-03 |
| 1578743597 | Jerry S. Alvis, D.d.s., P.a. | Exclusive Provider Organization | 5603 Duraleigh Rd, Suite 131, Raleigh, NC 27612-2688 | 2007-11-07 |
| 1558473132 | Elizabeth Marie Macpherson | Nurse Practitioner | 5603 Duraleigh Rd, Suite111, Raleigh, NC 27612-2688 | 2006-08-31 |
| 1912018375 | Ronald B Bean | Physician Assistant | 5603 Duraleigh Rd, Suite 111, Raleigh, NC 27612-2688 | 2006-08-31 |
| 1497790596 | Jerry Shumate Alvis | Dentist | 5603 Duraleigh Rd, Suite 131, Raleigh, NC 27612-2688 | 2006-06-20 |
| 1528029972 | Ginger Elizabeth Smith | Physician Assistant | 5603 Duraleigh Rd, Suite 111, Raleigh, NC 27612-2688 | 2006-03-28 |
| 1972508828 | Kelly T Blount | Physician Assistant | 5603 Duraleigh Rd, Suite 111, Raleigh, NC 27612-2688 | 2005-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538714068 | George J Henderon | Orthotist | 5313 Duraleigh Road, Ste 151, Raleigh, NC 27612 | 2019-08-01 |
| 1902399223 | Iain Knox Nathaniel Irwin | Marriage & Family Therapist | 7701 Alborz Dr, Raleigh, NC 27612 | 2018-06-12 |
| 1225525884 | Patterns Behavioral Services North Carolina, Inc | Assistant Behavior Analyst | 3738 National Dr, Ste 110, Raleigh, NC 27612 | 2018-04-19 |
| 1053820720 | The Art Counseling L.L.C. | Psychologist | 4610 Twisted Oaks Drive Apt 1807, Raleigh, NC 27612 | 2017-09-26 |
| 1376052431 | Amanda Steed | Speech-Language Pathologist | 5519 Hamstead Crossing, Raleigh, NC 27612 | 2017-09-21 |
| 1295250991 | Neal H. Patel Dds Pllc | Dentist | 7211 Shellburne Dr, Raleigh, NC 27612 | 2017-08-03 |
| 1811426109 | Marquita Randolph-breeden | Behavior Technician | 5816 Creedmoor Road, Suite 104, Raleigh, NC 27612 | 2017-06-08 |
| 1336518554 | Travis Edward Williams | Counselor | 4801 Glenwood Ave., Suite 200, Raleigh, NC 27612 | 2015-09-17 |
| 1831587476 | Harris Teeter LLC | Pharmacy | 2051 W Millbrook Road, Raleigh, NC 27612 | 2015-01-06 |
| 1780072975 | Harris Teeter LLC | Pharmacy | 2051 W. Millbrook Road, Raleigh, NC 27612 | 2014-12-23 |
| Find all providers in zip 27612 | ||||
| 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 |
|---|---|---|---|---|
| 1417590290 | Sarah Lyn Granahan | Specialist | 107 Windel Dr Ste 205, Raleigh, NC 27609-4471 | 2019-10-23 |
| 1629540323 | Sieara Kearney | Specialist | 5503 Metedeconk Ln, Raleigh, NC 27604-5404 | 2018-12-19 |
| 1821480872 | Sharon Hahn | Specialist | 6728 Eastbrook Dr, Raleigh, NC 27615-7309 | 2015-02-27 |
| 1184030611 | Life Without Limits Coaching and Counseling Pllc | Specialist | 841 Oxen Cir, Raleigh, NC 27603-9165 | 2014-07-04 |
| 1083029383 | Village Hands Foundation | Specialist | 5808 Departure Dr Ste 101, Raleigh, NC 27616-1934 | 2014-06-25 |
| 1346584620 | Danielle Blackwell | Specialist | 723 Saint Marys St, Raleigh, NC 27605-1424 | 2012-11-27 |
| 1053686113 | Duraleigh Gynecology Pa | Specialist | 2800 Blue Ridge Rd Ste 210, Raleigh, NC 27607-6477 | 2012-03-21 |
| 1578831541 | Christopher Mcclain | Specialist | 1630 Claiborne Ct, Raleigh, NC 27606-4603 | 2011-12-06 |
| 1720366610 | Bonny Reid | Specialist | 3122 Tanager St, Raleigh, NC 27606-3641 | 2011-07-27 |
| 1619276318 | Wakehealth Medical Group, Pa. | Specialist | 13200 New Falls of Neuse Rd, Ste 113, Raleigh, NC 27614-8239 | 2011-03-21 |
| Find all providers in RALEIGH | ||||
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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.