NPIMap

Organization Active NPI

Cullman Dermatology Clinic, P.C.

  • Dermatology Physician
  • Cullman, AL
National Provider Identifier
1003869751
Registry record updated May 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
18046 Issued in AL
Legal business name
CULLMAN DERMATOLOGY CLINIC, P.C.
Practice address
1205 County Road 1466
Cullman, AL 35058-0795
Phone
(256) 739-9711
Fax
(256) 739-9737
NPI assigned
May 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2008

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

Authorized official

Name
Steven M Skinner, M.D.
Title
President
Phone
(256) 739-9711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 18046 AL Primary

Addresses

Primary practice location

1205 County Road 1466
Cullman, AL 35058-0795

Mailing address

1205 County Road 1466
Cullman, AL 35058-0795
Phone (256) 739-9711

Other identifiers 2

IdentifierTypeStateIssuer
CC9291OtherRAILROAD MEDICARE
529700230MedicaidAL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210636800000",
    "number": "1003869751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 COUNTY ROAD 1466",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350580795",
            "telephone_number": "256-739-9711",
            "fax_number": "256-739-9737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 COUNTY ROAD 1466",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350580795",
            "telephone_number": "256-739-9711",
            "fax_number": "256-739-9737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CULLMAN DERMATOLOGY CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "256-739-9711",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "AL",
            "license": "18046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CC9291",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529700230",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cullman, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.