DR. LACEY BETH WALLS (NPI# 1790121689) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790121689 |
| Entity Type | Individual |
| Full Name | DR. LACEY BETH WALLS |
| Other Name | LACEY BETH ELWYN |
| Credential | D.O. |
| Practice Address |
335 Penny Ln Concord NC 28025-1221 |
| Practice Telephone | 7047845901 |
| Practice Fax Number | 7047210413 |
| Mailing Telephone | 7047845901 |
| Enumeration Date | 2013-05-17 |
| Last Update Date | 2019-12-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 2018-01570 | NC | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 276541 | NY | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | OS14737 | FL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 13660 S Jog Rd Ste 8, Delray Beach, FL 334463806 | 6186152500 | |
| 7421 N University Dr Ste 307, Tamarac, FL 333216102 | (618) 615-2500 |
| Street Address |
335 PENNY LN |
| City | CONCORD |
| State | NC |
| Zip Code | 28025-1221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720064116 | William D Hoover | Dermatology | 335 Penny Ln, Concord, NC 28025-1221 | 2005-12-19 |
| 1548647613 | Nathaniel Allen Slater | Dermatology | 335 Penny Ln, Concord, NC 28025-1221 | 2015-04-28 |
| 1982091005 | Matthew Hill Overton | Dermatology | 335 Penny Ln, Concord, NC 28025-1221 | 2015-04-16 |
| 1598197832 | Dhwani S Mehta | Dermatology | 335 Penny Ln, Concord, NC 28025-1221 | 2013-08-08 |
| 1891057204 | Sarah Beth Koch | Dermatology | 335 Penny Ln, Concord, NC 28025-1221 | 2012-06-12 |
| 1083891568 | Brian Scott Walther | Dermatology | 335 Penny Ln, Concord, NC 28025-1221 | 2008-01-27 |
| 1104873959 | Aaron Sidscott Wever | Dermatology | 335 Penny Ln, Concord, NC 28025-1221 | 2006-05-27 |
| 1437110772 | Dermatology Group of The Carolinas | Dermatology | 335 Penny Ln, Concord, NC 28025-1221 | 2006-03-28 |
| 1104802008 | Kapil Gupta | Pathology | 335 Penny Ln, Concord, NC 28025-1221 | 2005-12-22 |
| 1780660654 | Jon C Ter Poorten | Dermatology | 335 Penny Ln, Concord, NC 28025-1221 | 2005-12-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910729 | Renewed Mindset Therapeutic Services, Pllc | Social Worker | 349 Copperfield Blvd Suite L #334, Concord, NC 28025 | 2020-10-22 |
| 1194284380 | Carolinas Physicians Network Inc | Internal Medicine | 610 Alfred Brown Jr. Court, Concord, NC 28025 | 2019-03-18 |
| 1164913596 | Damarius Raymond Faggart | Counselor | 503 Amhurst Drive, Concord, NC 28025 | 2018-05-22 |
| 1437677085 | Kathryn Emily Kanauer | Counselor | 280 Executive Park Dr Ne, Concord, NC 28025 | 2017-09-05 |
| 1649794439 | Foster Health & Homecare, LLC | Home Health | 363 Church Street North, Suite 260-i, Concord, NC 28025 | 2017-08-02 |
| 1326569336 | Jessie Leigh Tilley-compton | Social Worker | 371 Amhurst St Sw, Concord, NC 28025 | 2017-06-29 |
| 1609305663 | Sarah Katherine Thompson | Licensed Practical Nurse | 248 Executive Park Dr, Concord, NC 28025 | 2017-06-05 |
| 1023463098 | Kiera Brown | Social Worker | 219 Lephillip Court, Concord, NC 28025 | 2016-04-27 |
| 1992169445 | Brittiny N. Ingram Vanterpool | Counselor | 250 Branchview Dr Sw, Concord, NC 28025 | 2016-04-11 |
| 1215399852 | The Charlotte-mecklenburg Hospital Authority | Clinic/Center | 840 Warren C. Coleman Blvd, Concord, NC 28025 | 2016-03-23 |
| Find all providers in zip 28025 | ||||
| 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 |
|---|---|---|---|---|
| 1518237825 | Carolinas Medical Center-northeast | Dermatology | 200 Medical Park Drive, Suite 320, Concord, NC 28025-0936 | 2012-01-03 |
| 1477707164 | Ebaa Mohammed Alawami | Dermatology | 248 Pleasant St Ste 103, Concord, NH 03301-2588 | 2008-11-08 |
| 1386777407 | Anthony J Aversa Md | Dermatology | 111 Loudon Rd, Concord, NH 03301-5605 | 2007-03-14 |
| 1124133277 | David E Geist | Dermatology | 54 Baker Avenue Ext Ste 305, Concord, MA 01742-2143 | 2006-08-20 |
| 1124006127 | Peter Muz | Dermatology | 54 Baker Avenue Ext 305, Concord, MA 01742-2143 | 2006-01-09 |
| 1689652257 | Kathleen Mary Joyce | Dermatology | 1620 Sudbury Rd, Concord, MA 01742-5800 | 2006-01-04 |
| 1720064116 | William D Hoover | Dermatology | 335 Penny Ln, Concord, NC 28025-1221 | 2005-12-19 |
| 1184619223 | Michael M Pugliese | Dermatology | 290 Baker Ave, Suite 220n, Concord, MA 01742-2189 | 2005-09-14 |
| 1679138879 | Apderm Massachusetts PC | Dermatology | 54 Baker Avenue Ext Ste 305, Concord, MA 01742-2143 | 2019-05-03 |
| 1548647613 | Nathaniel Allen Slater | Dermatology | 335 Penny Ln, Concord, NC 28025-1221 | 2015-04-28 |
| Find all providers in CONCORD | ||||
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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.