Organization Active NPI

Solstice Dermatology, PLLC

  • Dermatology Physician
  • Jackson, MS
National Provider Identifier
1003518663
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SOLSTICE DERMATOLOGY, PLLC
Practice address
1675 Lakeland Dr Ste 200
Jackson, MS 39216-4843
Phone
(769) 768-7546
NPI assigned
Mar 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ashley Emerson, MDNPI 1407296825
Title
Owner
Phone
(601) 589-1810

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X Primary
Procedural Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207NS0135X

Addresses

Primary practice location

1675 Lakeland Dr Ste 200
Jackson, MS 39216-4843

Mailing address

1675 Lakeland Dr Ste 200
Jackson, MS 39216-4843
Phone (769) 768-7546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231031003602 MS Part B Supplier - Clinic/Group Practice 2264888999 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson, MS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2286915Solstice Dermatology PLLC1675 Lakeland Dr Ste 200, Jackson, MS 39216Provider-performed microscopyAug 3, 2027

National Provider Directory

National Provider Directory

Locations

1675 Lakeland Dr
Ste 200
Jackson, MS 39216
Phone (601) 589-1810

120 District Blvd
Ste D105
Jackson, MS 39211

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734652800000",
    "number": "1003518663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 LAKELAND DR STE 200",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164843",
            "telephone_number": "769-768-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 LAKELAND DR STE 200",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164843",
            "telephone_number": "769-768-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLSTICE DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-20",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A",
        "authorized_official_last_name": "EMERSON",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-589-1810",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.