DR. JOSE RAUL PENA (NPI# 1598741563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598741563 |
| Entity Type | Individual |
| Full Name | DR. JOSE RAUL PENA |
| Credential | M.D. |
| Practice Address |
9604 Holly Point Dr Huntersville NC 28078-4913 |
| Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
| Practice Telephone | 7043165070 |
| Practice Fax Number | 7043165075 |
| Mailing Telephone | 7043165070 |
| Mailing Fax Number | 7043165075 |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2020-10-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 26801 | NC | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 009000253 | NC | Allopathic & Osteopathic Physicians |
| N | 207ZD0900X |
Pathology Specialization: Dermatopathology |
009000253 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5900708 | 05 | |
| NC | 218605 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820564 | Jose Manuel Pena | Behavior Technician | 69 Nw 45th Ave, Miami, FL 33126-5341 | 2020-10-26 |
| 1265081657 | Jose M Pena | Home Health Aide | 816 Florida St, San Antonio, TX 78210 | 2019-09-09 |
| 1457754392 | Jose Pena | Nurse Practitioner | 15641 Sw 8th Ln, Miami, FL 33194-2409 | 2014-10-07 |
| 1285889386 | Jose A Pena | Obstetrics & Gynecology | 4735 Ave Isla Verde, Apt 3d, Carolina, PR 00979-5442 | 2008-11-18 |
| 1205875721 | Jose Fernado Pena | Internal Medicine | 307 N Salinas Blvd, Donna, TX 78537-2929 | 2006-06-06 |
| 1982670931 | Jose Rolando Pena | Family Medicine | K2 Calle 4, Rio Grande, PR 00745-2823 | 2006-02-28 |
| 1407346927 | Jose R Pena IIi | Family Medicine | 1600 Providence Dr, Waco, TX 76707-2261 | 2018-05-10 |
| 1770013583 | Jose Manuel Pena | Pediatrics | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2017-06-14 |
| 1134674112 | Jose Pena | Counselor | 730 Medical Center Ct, Chula Vista, CA 91911-6618 | 2016-08-19 |
| 1871942359 | Jose Martin Pena | Pharmacist | 200 Fairmont Shopping Ctr, Pacifica, CA 94044-1240 | 2016-06-06 |
| Street Address |
9604 HOLLY POINT DR |
| City | HUNTERSVILLE |
| State | NC |
| Zip Code | 28078-4913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487641429 | Advanced Dermatology Center, Pa | Dermatology | 9604 Holly Point Dr, Huntersville, NC 28078-4913 | 2005-10-04 |
| 1417438839 | Melissa Wriglesworth | Physician Assistant | 9604 Holly Point Dr, Huntersville, NC 28078-4913 | 2018-08-23 |
| 1932637634 | Regina Diane Augter | Nurse Practitioner | 9604 Holly Point Dr, Huntersville, NC 28078 | 2017-05-25 |
| 1992259378 | Eric Alan Knuth | Physician Assistant | 9604 Holly Point Dr, Huntersville, NC 28078-4913 | 2016-08-15 |
| 1699953166 | Erin S. Dice | Physician Assistant | 9604 Holly Point Dr, Huntersville, NC 28078-4913 | 2008-02-06 |
| 1568524023 | Melinda Ruth Asfaw | Physician Assistant | 9604 Holly Point Dr, Huntersville, NC 28078-4913 | 2006-12-14 |
| 1396751640 | Novant Medical Group, Inc. | Dermatology | 9604 Holly Point Dr, Huntersville, NC 28078-4913 | 2006-07-31 |
| 1447266796 | Jean Marie Kois | Dermatology | 9604 Holly Point Dr, Huntersville, NC 28078-4913 | 2006-07-31 |
| 1396790317 | Colene Marie Calo | Dermatology | 9604 Holly Point Dr, Huntersville, NC 28078-4913 | 2006-05-25 |
| 1043296817 | Mary M Cummins | Physician Assistant | 9604 Holly Point Dr, Huntersville, NC 28078-4913 | 2005-12-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538787718 | John M. Bakarich, Dds, Pllc | Dentist | 15810 Northcross Drive, Suite A, Huntersville, NC 28078 | 2020-07-14 |
| 1316587082 | Blake Allen Klessig | Chiropractor | 8936 Northpointe Executive Park Dr, Suite 195, Huntersville, NC 28078 | 2020-01-10 |
| 1922644830 | Steven James Underwood | Physical Therapist | Aldersgate Ccrc, 3800 Shamrock Drive, Charlotte, NC 28078 | 2019-11-26 |
| 1851856306 | Jessica Runnion | Behavior Technician | 14625 Reese Blvd, Apartment 208, Huntersville, NC 28078 | 2019-02-08 |
| 1568935401 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 111 Commerce Centre Drive, Suite 305, Huntersville, NC 28078 | 2019-01-03 |
| 1932691763 | Shakira Grier | Massage Therapist | 15905 Brookway Drive, Ste 4202, Huntersville, NC 28078 | 2018-06-06 |
| 1457850596 | Chudney Drew | Counselor | 10224 Hickorywood Hill Ave Ste 201, Huntersville, NC 28078 | 2018-02-05 |
| 1215457122 | Amy Nicole Castongia | Counselor | 10511 Drake Hill Dr, Huntersville, NC 28078 | 2017-06-21 |
| 1457714057 | Robin D Disbro | Registered Nurse | 6216 Colonial Garden Drive, Huntersville, NC 28078 | 2016-03-31 |
| 1144695545 | Huntersville H&r Ops Limited Partnership | Skilled Nursing Facility | 13835 Boren Street, Huntersville, NC 28078 | 2015-12-10 |
| Find all providers in zip 28078 | ||||
| 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 |
|---|---|---|---|---|
| 1134539638 | William Hoover IIi | Dermatology | 9735 Kincey Ave Ste 102, Huntersville, NC 28078 | 2014-05-06 |
| 1487641429 | Advanced Dermatology Center, Pa | Dermatology | 9604 Holly Point Dr, Huntersville, NC 28078-4913 | 2005-10-04 |
| 1396751640 | Novant Medical Group, Inc. | Dermatology | 9604 Holly Point Dr, Huntersville, NC 28078-4913 | 2006-07-31 |
| 1447266796 | Jean Marie Kois | Dermatology | 9604 Holly Point Dr, Huntersville, NC 28078-4913 | 2006-07-31 |
| 1396790317 | Colene Marie Calo | Dermatology | 9604 Holly Point Dr, Huntersville, NC 28078-4913 | 2006-05-25 |
| 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 | ||||
| City | HUNTERSVILLE |
| Zip Code | 28078 |
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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.