Organization Active NPI

Carolina Skin Institute, P.a

  • MOHS-Micrographic Surgery Physician
  • Brevard, NC
National Provider Identifier
1033922737
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
Legal business name
CAROLINA SKIN INSTITUTE, P.A
Practice address
89 Hospital Dr Ste a-Up1
Brevard, NC 28712-4837
Phone
(828) 570-5505
Fax
(828) 259-2581
NPI assigned
Jan 28, 2025
Last updated
Jan 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Authorized official

Name
Stephanie Myracle, MDNPI 1447453402
Title
Owner
Phone
(828) 570-5505

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: 193200000X MULTI-SPECIALTY GROUP 207N00000X
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X Primary

Addresses

Primary practice location

89 Hospital Dr Ste a-Up1
Brevard, NC 28712-4837

Mailing address

89 Hospital Dr Ste a-Up1
Brevard, NC 28712-4837
Phone (828) 570-5505

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250402000162 NC Part B Supplier - Clinic/Group Practice 1254854078 Receives reassigned benefits from 2 practitioners
Practice locations: Brevard, NC

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
34D2320011Carolina Skin Institute, PA89 Hospital Drive, Suite a-Up1, Brevard, NC 28712RegistrationMar 10, 2027

National Provider Directory

National Provider Directory

Locations

89 Hospital Dr
Ste AUP1
Brevard, NC 28712
Phone (828) 570-5505

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1738022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738195200000",
    "number": "1033922737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 HOSPITAL DR STE A-UP1",
            "city": "BREVARD",
            "state": "NC",
            "postal_code": "287124837",
            "telephone_number": "828-570-5505",
            "fax_number": "828-259-2581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 HOSPITAL DR STE A-UP1",
            "city": "BREVARD",
            "state": "NC",
            "postal_code": "287124837",
            "telephone_number": "828-570-5505",
            "fax_number": "828-259-2581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA SKIN INSTITUTE, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-28",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A",
        "authorized_official_last_name": "MYRACLE",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-570-5505",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brevard, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.