Dermatology Laser and Vein Specialists of the Carolina'S, PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY LASER AND VEIN SPECIALISTS OF THE CAROLINA'S, PLLC

Practice address

1918 Randolph Rd
Suite 550
Charlotte, NC 28207-1100

Phone

(704) 375-6766

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Girish S Munavalli, M.DNPI 1215910336

Title

Medical Director

Phone

(704) 375-6766

Specialties & licenses 2

Addresses

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 16

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

• Girish Somashekhar Munavalli, M.D.

  • MOHS-Micrographic Surgery Physician
  • Charlotte, NC
  • NPI 1215910336
  Medicare reassignment Care Compare group NPD Authorized official
• Monnie Jordan Drummond, PA-C

  • Physician Assistant
  • Matthews, NC
  • NPI 1760260681
  Medicare reassignment Care Compare group NPD
• Leila Esmaeili

  • Physician Assistant
  • Charlotte, NC
  • NPI 1518558733
  Medicare reassignment Care Compare group NPD
• Megan Elizabeth Klinck, MMSC, PA-C

  • Physician Assistant
  • Charlotte, NC
  • NPI 1649157074
  Medicare reassignment Care Compare group NPD
• Payman Kosari, M.D.

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1942519673
  Medicare reassignment Care Compare group NPD
• Hayley Michelle Leight-Dunn, M.D.

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1609238666
  Medicare reassignment Care Compare group NPD
• Amit Om, M.D.

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1336599232
  Medicare reassignment Care Compare group NPD
• Isabella Camacho-Hubbard

  • Student in an Organized Health Care Education/Training Program
  • Houston, TX
  • NPI 1154940955

  Dermatology, NC

  Medicare reassignment Care Compare group NPD
• Aaron T Blackmer, P.A

  • Medical Physician Assistant
  • Charlotte, NC
  • NPI 1255321972
  Medicare reassignment Care Compare group
• Amber Marie Blair, PA

  • Physician Assistant
  • Charlotte, NC
  • NPI 1366782781
  Medicare reassignment Care Compare group
• Katherine E Daley, P.A.

  • Medical Physician Assistant
  • Charlotte, NC
  • NPI 1720314289
  Medicare reassignment Care Compare group
• Dana Meredith Dorenfeld, P.A.

  • Medical Physician Assistant
  • Charlotte, NC
  • NPI 1750495511
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198627200000",
    "number": "1083700207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 RANDOLPH RD",
            "address_2": "SUITE 550",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071100",
            "telephone_number": "704-375-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 RANDOLPH RD",
            "address_2": "SUITE 550",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071100",
            "telephone_number": "704-375-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY LASER AND VEIN SPECIALISTS OF THE CAROLINA'S, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-12-26",
        "status": "A",
        "authorized_official_last_name": "MUNAVALLI",
        "authorized_official_first_name": "GIRISH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "704-375-6766",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derive Health, PA
• Artem Derkachev
• Chelsea R Dermady
• Dermatologic Surgery of the Carolinas LLC
• Dermatology Care of Charlotte, PA
• Dermatology Practice of the Carolinas PA
• Dermatology Specialists of Charlotte PA
• Sarah Shaw Dermes, PA-C
• Jenna A. Derosa
• Elizabeth Derouin, PHD

• Dermatology Physician in Charlotte, NC
• Providers in Charlotte, 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 Dec 26, 2007; 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.