Organization Active NPI

Dermatology Care Center LLC

  • Clinical & Laboratory Dermatological Immunology Physician
  • Windsor, CT
National Provider Identifier
1063350957
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical & Laboratory Dermatological Immunology PhysicianTaxonomy code 207NI0002X
Legal business name
DERMATOLOGY CARE CENTER LLC
Practice address
74 Mack St
Windsor, CT 06095-2759
Phone
(860) 219-1922
Fax
(860) 219-9385
NPI assigned
Mar 23, 2026
Last updated
Mar 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Authorized official

Name
Dr. Sharon M Christie, MDNPI 1912908393
Title
Owner
Phone
(860) 916-3939

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical & Laboratory Dermatological Immunology Physician 207NI0002X NU Primary

Addresses

Primary practice location

74 Mack St
Windsor, CT 06095-2759

Mailing address

74 Mack St
Windsor, CT 06095-2759
Phone (860) 916-3939

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260504006393 CT Part B Supplier - Clinic/Group Practice 3072081512 Receives reassigned benefits from 1 practitioner
Practice locations: Windsor, CT

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
07D2341779Dermatology Care Center74 Mack St, Windsor, CT 06095Provider-performed microscopyApr 7, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1774224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774224000000",
    "number": "1063350957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 MACK ST",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952759",
            "telephone_number": "860-916-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 MACK ST",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952759",
            "telephone_number": "860-219-1922",
            "fax_number": "860-219-9385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-23",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A",
        "authorized_official_last_name": "CHRISTIE",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-916-3939",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207NI0002X",
            "taxonomy_group": "",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; 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.