Organization Active NPI

Forefront Dermatology, S.C.

Doing business as Laing Dermatology, A Forefront Dermatology Practice

  • Dermatology Physician
  • Knightdale, NC
National Provider Identifier
1083277735
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
FOREFRONT DERMATOLOGY, S.C.
Doing business as
Laing Dermatology, A Forefront Dermatology Practice
Practice address
6807 Knightdale Blvd Ste C
Knightdale, NC 27545-6563
Phone
(919) 217-5510
Fax
(919) 217-5501
NPI assigned
Apr 18, 2019
Last updated
Jan 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Authorized official

Name
Denise Anger
Title
Sr. Director, Provider Enrollment
Phone
(920) 663-9022

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary
MOHS-Micrographic Surgery Physician 207ND0101X NU
Procedural Dermatology Physician 207NS0135X NU

Addresses

Primary practice location

6807 Knightdale Blvd Ste C
Knightdale, NC 27545-6563

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other names 1

  • Laing Dermatology, A Forefront Dermatology Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180821002003 NC Part B Supplier - Clinic/Group Practice 3779471701 Receives reassigned benefits from 22 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Nags Head, NC; Knightdale, NC; Kitty Hawk, NC; Holly Springs, NC; Goldsboro, NC; Elizabeth City, NC; Charlotte, NC; Cary, NC

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
34D2014725Forefront Dermatology, SC6807 Knightdale Boulevard, Suite C, Knightdale, NC 27545ComplianceMar 5, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1555545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672963200000",
    "number": "1083277735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6807 KNIGHTDALE BLVD STE C",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275456563",
            "telephone_number": "919-217-5510",
            "fax_number": "919-217-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREFRONT DERMATOLOGY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-18",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A",
        "authorized_official_last_name": "ANGER",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "SR. DIRECTOR, PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "920-663-9022"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laing Dermatology, A Forefront Dermatology Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Knightdale, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.