BECKLEY DERMATOLOGY INC. (NPI# 1912479056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912479056 |
| Entity Type | Organization |
| Organization Name | BECKLEY DERMATOLOGY INC. |
| Practice Address |
300 Kenton Dr Ste 2 Charleston WV 25311-1266 |
| Mailing Address |
136 Linden Dr Ste 104 Winchester VA 22601-6900 |
| Practice Telephone | 3043451966 |
| Practice Fax Number | 3043451978 |
| Mailing Telephone | 5406783588 |
| Mailing Fax Number | 5406789025 |
| Enumeration Date | 2018-12-31 |
| Last Update Date | 2018-12-31 |
| Authorized Official Name | NELSON E. VELAZQUEZ (OWNER) |
| Authorized Official Telephone | 3042522673 |
| Authorized Official Credential | DO |
| Is Organization Subpart | Y |
| Parent Organization Name | BECKLEY DERMATOLOGY INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Dermatology Associates & Surgery Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275005316 | Beckley Dermatology Inc. | Dermatology | 1000 Tavern Rd Ste 400, Martinsburg, WV 25401-2853 | 2018-12-31 |
| 1942772082 | Beckley Dermatology Inc. | Dermatology | 1401 Hospital Dr Ste 101, Hurricane, WV 25526-9239 | 2018-12-31 |
| 1740752880 | Beckley Dermatology Inc. | Dermatology | 300 Prosperity Ln Ste 207, Logan, WV 25601-3743 | 2018-12-31 |
| 1891267936 | Beckley Dermatology Inc. | Dermatology | 1110 Professional Ct Ste 201, Hagerstown, MD 21740-5945 | 2018-12-31 |
| 1568076180 | Beckley Dermatology Inc. | Dermatology | 150 E 2nd Ave, Williamson, WV 25661-3602 | 2020-09-01 |
| 1578035606 | Beckley Dermatology Inc. | Dermatology | 508 New Hope Rd Ste 102, Princeton, WV 24740-2265 | 2018-12-31 |
| 1720089279 | Beckley Dermatology Inc. | Dermatology | 94 Brookshire Lane, Beckley, WV 25801-6765 | 2005-08-09 |
| Street Address |
300 KENTON DR STE 2 |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25311-1266 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184225476 | Darlene Lacy-carter | Technician | 1406 Milton Street, Charleston, WV 25311 | 2020-11-04 |
| 1942810452 | Joshua Reese | Technician | 1248 Valley Grove Rd, Charleston, WV 25311 | 2020-08-10 |
| 1538710785 | Pamela White | Technician | 542 Harmony Hollow Road, Charleston, WV 25311 | 2019-09-27 |
| 1780104083 | The Stairlift People, Inc | Public Health or Welfare | 2510 Kanawha Blvd East, Charleston, WV 25311 | 2017-06-27 |
| 1902271505 | Mary Workman | Registered Nurse | 1520 Wahington Street East, Charleston, WV 25311 | 2015-12-08 |
| 1871966564 | Ashley Nicole Lester | Occupational Therapy Assistant | 1000 Association Dr., Charleston, WV 25311 | 2015-11-04 |
| 1548671530 | Holly Markins | Social Worker | 300 Tracy Way, Charleston, WV 25311 | 2014-05-13 |
| 1124453964 | West Virginia Health Right, Inc. | Clinic/Center | 1520 Washington St. E., Charleston, WV 25311 | 2013-09-12 |
| 1457678005 | Sarah Lyn Tussey | Occupational Therapy Assistant | 1 Supthin Dr, Charleston, WV 25311 | 2010-04-22 |
| 1639344708 | Daymark Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1592 Washington Street East, Suite 2, Charleston, WV 25311 | 2008-04-29 |
| Find all providers in zip 25311 | ||||
| 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 |
|---|---|---|---|---|
| 1700272978 | Leah Swanson | Dermatology | 135 Rutledge Ave # Msc578, Charleston, SC 29425-8903 | 2015-04-14 |
| 1770996621 | David Mark Perry | Dermatology | 48 Folly Road Blvd, Charleston, SC 29407-7507 | 2014-06-09 |
| 1891106811 | Sarah M. Derrington | Dermatology | 9217 University Blvd., Ste C1b, Charleston, SC 29406 | 2014-05-13 |
| 1649619404 | Richard Pierce | Dermatology | 776 Daniel Ellis Dr Ste 1a, Charleston, SC 29412-3095 | 2013-06-14 |
| 1528096831 | Brian Curtis Leach | Dermatology | 135 Rutledge Avenue, Dept of Dermatology & Dermatologic Surgery, Charleston, SC 29425 | 2006-06-28 |
| 1588629166 | Stephen Kirby Milroy | Dermatology | 3100 Mccorkle Ave Se, Ste 809, Charleston, WV 25304-1223 | 2006-04-18 |
| 1255393484 | James G Simpson | Dermatology | 48 Folly Road, Charleston, SC 29407 | 2006-04-04 |
| 1396713780 | Jeffrey K Mckenna | Dermatology | 100 Deerpath, Charleston, IL 61920-9427 | 2006-03-10 |
| 1689648123 | Erin Alyson Walker | Dermatology | 1364 Ashley River Rd, Charleston, SC 29407-5347 | 2006-02-13 |
| 1003893868 | Hudson C Rogers | Dermatology | 9295 Medical Plaza Dr, Suite B, Charleston, SC 29406-9137 | 2005-12-22 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 25311 |
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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.