ATLANTIC DERMATOLOGY (NPI# 1730596685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730596685 |
| Entity Type | Organization |
| Organization Name | ATLANTIC DERMATOLOGY |
| Practice Address |
3600 Sea Mountain Hwy Ste A Little River SC 29566-8161 |
| Mailing Address |
Po Box 100523 Florence SC 29502-0523 |
| Practice Telephone | 4239637282 |
| Mailing Telephone | 8436695162 |
| Mailing Fax Number | 8436674573 |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2014-09-15 |
| Authorized Official Name | DR. KENNETH RAY WARRICK (OWNER) |
| Authorized Official Telephone | 4239637282 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | SC | Allopathic & Osteopathic Physicians | |
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
SC | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Atlantic Dermatology Associates P.C. | 1101 First Colonial Road Ste. 200, Va Beach, Virginia 23454 |
| Street Address |
3600 SEA MOUNTAIN HWY STE A |
| City | LITTLE RIVER |
| State | SC |
| Zip Code | 29566-8161 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134736309 | Holly Leanne Poplin | Nurse Practitioner | 3600 Sea Mountain Hwy, Suite C, Main Street Physicians/sc House Calls Inc, Little River, SC 29566 | 2020-09-30 |
| 1619534112 | Mcleod Loris Seacoast Hospital | Pharmacy | 4000 Hwy 9 East, Outpatient Pharmacy, Little River, SC 29566 | 2019-05-21 |
| 1366960585 | Sasha Hayes | Dentist | 1247 Highway 17 S, Little River, SC 29566 | 2017-09-07 |
| 1639557531 | Mary Lucille Harding | Nurse Practitioner | 3600 Sea Mountain Hwy, Suite, Main Street Physicians, Little River, SC 29566 | 2015-05-12 |
| 1770900771 | Dottie Randall-cox | Registered Nurse | 107 Hwy 57-north, Little River, SC 29566 | 2014-03-27 |
| 1689091688 | Carolyn Howe | Registered Nurse | 107 Highway 57 North, Dhec, Little River, SC 29566 | 2014-03-27 |
| 1376977884 | Southern Surgical Group, LLC | Specialist | 3600 Sea Mountain Hwy Suite A, Little River, SC 29566 | 2013-09-03 |
| 1144570888 | Laura Gore | Pharmacist | 2492 Hwy 9 East, Little River, SC 29566 | 2012-09-10 |
| 1255611406 | Belliams Home Health Services | Home Health | 687c Williamson Rd, Longs, SC 29566 | 2011-08-19 |
| 1083878813 | Lacie E. Edmison | Internal Medicine | 3980 Highway 9 E Ste 320, Little River, SC 29566 | 2008-07-10 |
| Find all providers in zip 29566 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467016600 | Marcus Hutchison | Dermatology | 688 Albright Rd Ste 101, Rock Hill, SC 29730-6290 | 2019-04-23 |
| 1841511623 | Susan Fellows Vanepps | Dermatology | 8590 San Marcello Dr, #101, Myrtle Beach, SC 29579-5281 | 2010-06-16 |
| 1992726269 | The Palmetto Skin and Laser Center LLC | Dermatology | 1563 Health Care Dr, Rock Hill, SC 29732-3858 | 2006-07-22 |
| 1114902269 | Timothy Gerrard Woodall | Dermatology | 1563 Healthcare Dr, Rock Hill, SC 29732 | 2005-12-13 |
| 1639164528 | John Michael Humeniuk | Dermatology | 21 Memorial Medical Dr, Greenville, SC 29605-4407 | 2005-09-16 |
| 1346330271 | Paul L Ross | Dermatology | 109 Bee St, Charleston, SC 29401-5703 | 2006-10-13 |
| 1912950775 | Rogers Dermatology, Pa | Dermatology | 3b Cleveland Ct, Greenville, SC 29607-2414 | 2006-05-19 |
| 1528048139 | Edward George Butler II | Dermatology | 109 Bee St, Charleston, SC 29401-5703 | 2006-01-19 |
| 1730165465 | Richard Eric White | Dermatology | 1563 Healthcare Dr, Rock Hill, SC 29732-3858 | 2005-12-15 |
| City | LITTLE RIVER |
| Zip Code | 29566 |
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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.