Individual provider Active NPI

Rene Bermudez, DO

  • MOHS-Micrographic Surgery Physician
  • Whiteville, NC
National Provider Identifier
1003895004
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
2005-00626 Issued in NC
Practice address
720 Jefferson St
Whiteville, NC 28472-3706
Phone
(910) 251-9944
Fax
(910) 763-4666
NPI assigned
Jan 10, 2006
Last updated
Feb 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 2005-00626 NC
MOHS-Micrographic Surgery Physician 207ND0101X 2005-00626 NC Primary

Addresses

Primary practice location

720 Jefferson St
Whiteville, NC 28472-3706

Mailing address

1099 Medical Center Dr Ste 201
Wilmington, NC 28401-7346
Phone (910) 251-9944

Other practice location 1

5272 Ocean Hwy W
Shallotte, NC 28470-4006
Phone (910) 251-9944

Other practice location 2

125 Fox Hollow Rd Ste 101
Pinehurst, NC 28374-8594
Phone (910) 684-5211

Other practice location 3

1099 Medical Center Dr Ste 100 and 201
Wilmington, NC 28401-7346
Phone (910) 251-9944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050712001217 NC Practitioner - Dermatology 2961438809 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Philadelphia College of Osteopathic Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Dermatology PAGroup PAC ID 7012971609, 52 clinicians

Practice addresses (Care Compare)

720 Jefferson St
Whiteville, NC 28472-3706
Phone (910) 251-9944

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision105
Removal of skin lesions169
Removal of skin cancer907
Removal of nail tissue1-10
Skin biopsy98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2005-00626NCMDMOHS-Micrographic Surgery Physician
4705OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority Dermatology CurrentSince Dec 1, 2013 Accepting new patients
Southern Dermatology, P.a. CurrentSince Nov 15, 2021 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
Dermatology Center of Shelby PA Dermatology CurrentSince Sep 6, 2017 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Dec 1, 2013 Accepting new patients
Anne Arundel Dermatology Affiliates PC Dermatology Past Accepting new patients
Carolina Skin Care, PA Dermatology PastSince May 9, 1997 Accepting new patients

Locations

1306 Concourse Dr
Ste 201
Linthicum Heights, MD 21090

1085 NE Gateway Ct NE
#200A
Concord, NC 28025
Phone (704) 403-8650

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

200 Medical Park Dr
Ste 320
Concord, NC 28025
Phone (704) 403-2760

200 Medical Park Dr
Ste 460
Concord, NC 28025
Phone (704) 403-2777

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

8560 Cook St
Mt Pleasant, NC 28124
Phone (704) 403-1911

125 Fox Hollow Rd
Ste 101
Pinehurst, NC 28374
Phone (910) 295-7546

4201 Lake Boone Trl
Ste 200
Raleigh, NC 27607
Phone (919) 782-2152

5272 Ocean Hwy W
Shallotte, NC 28470
Phone (888) 501-5597

935 Wyke Rd
Shelby, NC 28150
Phone (704) 481-1142

720 Jefferson St
Whiteville, NC 28472
Phone (910) 642-5832

1099 Medical Center Dr
Ste 100
Wilmington, NC 28401

1099 Medical Center Dr
Ste 200
Wilmington, NC 28401

1099 Medical Center Dr
Ste 201
Wilmington, NC 28401
Phone (910) 251-9444

1099 Medical Center Dr
Unit 201100A
Wilmington, NC 28401

123 Fox Rd
Knoxville, TN 37922
Phone (865) 342-5811

Interoperability endpoints

  • Direct secure messaging: rbermudez@aadermaffiliates.emadirect.md
  • Direct secure messaging: rbermudez@ncderm.emadirect.md

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1003895004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 MEDICAL CENTER DR STE 201",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017346",
            "telephone_number": "910-251-9944",
            "fax_number": "910-763-4666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 JEFFERSON ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284723706",
            "telephone_number": "910-251-9944",
            "fax_number": "910-763-4666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5272 Ocean Hwy W",
            "address_purpose": "LOCATION",
            "city": "Shallotte",
            "state": "NC",
            "postal_code": "284704006",
            "country_code": "US",
            "telephone_number": "910-251-9944",
            "fax_number": "910-763-4666",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 Fox Hollow Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Pinehurst",
            "state": "NC",
            "postal_code": "283748594",
            "country_code": "US",
            "telephone_number": "910-684-5211",
            "fax_number": "910-857-6647",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1099 Medical Center Dr Ste 100 and 201",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284017346",
            "country_code": "US",
            "telephone_number": "910-251-9944",
            "fax_number": "910-763-4666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERMUDEZ",
        "first_name": "RENE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "2005-00626",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NC",
            "license": "2005-00626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteville, NC

Sources for this page

Verify at the official NPI Registry.