Brentwood Skin Clinic PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

37546 Issued in TN

Legal business name

BRENTWOOD SKIN CLINIC PLLC

Practice address

5505 Edmondson Pike
Suite 10
Nashville, TN 37211-5872

Phone

(615) 810-8730

Fax

(615) 810-8731

NPI assigned

Oct 3, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Charles Austin Mitchell III, MD

Title

President/Owner

Phone

(615) 810-8730

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511222400000",
    "number": "1043647142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5505 EDMONDSON PIKE",
            "address_2": "SUITE 10",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372115872",
            "telephone_number": "615-810-8730",
            "fax_number": "615-810-8731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 EDMONDSON PIKE",
            "address_2": "SUITE 10",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372115872",
            "telephone_number": "615-810-8730",
            "fax_number": "615-810-8731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENTWOOD SKIN CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-03",
        "last_updated": "2017-11-21",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "AUSTIN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "615-810-8730",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "TN",
            "license": "37546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brentwood East Pediatrics
• Brentwood Eye Clinic
• Brentwood Eyecare, LLC
• Brentwood OB GYN
• Brentwood Operations, LLC
• Brentwood Springs Detox
• Brentwood Surgery Clinic, P.C.
• Kristy Breshears
• Phillip L Bressman, M.D.
• Timothy Andrew Breuer, PH.D.

• Dermatology Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Dermatology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; 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.