Mark S Dermer, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

2009-00338 Issued in NC

Practice address

920 Church St N
NE OB/GYN Hospitalist Services
Concord, NC 28025-2927

Phone

(704) 403-1632

Fax

(704) 403-1356

NPI assigned

Jun 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Carolinas Medical Center-Northeast

  • Endocrinology, Diabetes & Metabolism Physician
  • Huntersville, NC
  • NPI 1134433378
  NPD (past)
• Concord Women'S Specialty Care, Inc.

  • Obstetrics & Gynecology Physician
  • Concord, NC
  • NPI 1144486333
  NPD (past)

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250121600000",
    "number": "1023055977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 CHURCH ST N",
            "address_2": "NE OB/GYN HOSPITALIST SERVICES",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252927",
            "telephone_number": "704-403-1632",
            "fax_number": "704-403-1356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 CHURCH ST N",
            "address_2": "NE OB/GYN HOSPITALIST SERVICES",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252927",
            "telephone_number": "704-403-1632",
            "fax_number": "704-403-1356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERMER",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2009-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SC",
            "license": "13228",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2009-00338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132289",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "232009",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5911607",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dennis R Lockney, DDS
• Alicia N Dennis, PA-C
• Madena Dennis
• Anna Ingeborg Depaulis, MD
• Dermatology Group of the Carolinas
• Rhode Desauguste, PMHNP
• Cynthia Cheung Desilva, RPH
• Mary Jean Detchemendy, CRNA
• Tashana Detwiler, DMD
• Mary Elizabeth Devlin

• Obstetrics & Gynecology Physician in Concord, NC
• Providers in Concord, NC by specialty
• Obstetrics & Gynecology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2009; 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.