Foothills Family Dermatology

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

FOOTHILLS FAMILY DERMATOLOGY

Practice address

109 E Fleming Dr Ste 106
Morganton, NC 28655-3799

Phone

(828) 475-2646

NPI assigned

Nov 4, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Kim D Edhegard II, MDNPI 1487855680

Title

Dermatologist

Phone

(828) 475-2646

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kim D Edhegard, M.D.

  • Dermatology Physician
  • Morganton, NC
  • NPI 1487855680
  Medicare reassignment Care Compare group NPD Authorized official
• Anna Edhegard, MD

  • Dermatology Physician
  • Morganton, NC
  • NPI 1164657391

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618185600000",
    "number": "1043811128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3583",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "28680",
            "telephone_number": "828-475-2646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 E FLEMING DR STE 106",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286553799",
            "telephone_number": "828-475-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILLS FAMILY DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-04",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A",
        "authorized_official_last_name": "EDHEGARD",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DERMATOLOGIST",
        "authorized_official_telephone_number": "828-475-2646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487855680",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164657391",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Focus Behvioral Health Services, LLC
• Carly Folger-Bumgarner, SLP
• Foothills Area Mental Health
• Foothills Area Program
• Foothills Area Program
• Foothills Mental Health
• Foothills Mental Health Detox
• Foothills Pediatric Therapy, PLLC
• Foothills Prosthetics LLC
• Richard Luke Ford

• Dermatology Physician in Morganton, NC
• Providers in Morganton, NC by specialty
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.