Individual provider Active NPI

Brian Scott Walther, D.O.

  • Dermatology Physician
  • Concord, NC
National Provider Identifier
1083891568
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
200800727 Issued in NC
Practice address
335 Penny LN
Concord, NC 28025-1221
Phone
(704) 784-5901
Fax
(704) 721-0413
NPI assigned
Jan 27, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 200800727 NC Primary

Addresses

Primary practice location

335 Penny LN
Concord, NC 28025-1221

Mailing address

335 Penny LN
Concord, NC 28025-1221
Phone (704) 784-5901

Other practice location 1

525 Corporate Circle
Salisbury, NC 28147-8074
Phone (704) 784-5901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080702000680 NC Practitioner - Dermatology 5496827669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Philadelphia College of Osteopathic Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Group of the CarolinasGroup PAC ID 3678514759, 24 clinicians

Practice addresses (Care Compare)

335 Penny LN
Concord, NC 28025-1221
Phone (704) 784-5907

Merit-based Incentive Payment System (MIPS)

Final score
85.93 of 100Reported as group
Quality
69.47
Promoting interoperability
100
Improvement activities
40
Cost
83.64

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision22
Removal of tissue1-10
Removal of skin lesions1245
Removal or shaving of skin growth44
Skin biopsy364

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
200800727NCMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Group of the Carolinas Dermatology CurrentSince Jul 1, 2008 Accepting new patients

Locations

335 Penny Ln
Concord, NC 28025
Phone (704) 784-5901

525 Corporate Cir
Salisbury, NC 28147
Phone 7047845901 ext. 3079

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1083891568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 PENNY LN",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251221",
            "telephone_number": "704-784-5901",
            "fax_number": "704-721-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 PENNY LN",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251221",
            "telephone_number": "704-784-5901",
            "fax_number": "704-721-0413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 Corporate Circle",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281478074",
            "country_code": "US",
            "telephone_number": "704-784-5901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTHER",
        "first_name": "BRIAN",
        "middle_name": "SCOTT",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-27",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "200800727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.