NPIMap

Organization Active NPI

Newport Dermatology PLLC

  • Clinic/Center
  • Newport, NC
National Provider Identifier
1093063216
Registry record updated Oct 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
30120 Issued in NC
Legal business name
NEWPORT DERMATOLOGY PLLC
Practice address
285 Howard Blvd
Newport, NC 28570-7927
Phone
(252) 223-3405
Fax
(252) 223-4216
NPI assigned
Aug 20, 2012
Last updated
Oct 30, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2013

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

Authorized official

Name
Dr. Maurice Dana, M.D.NPI 1437294584
Title
Sole Member
Phone
(252) 223-4054

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 30120 NC Primary

Addresses

Primary practice location

285 Howard Blvd
Newport, NC 28570-7927

Mailing address

PO Box 1689
Newport, NC 28570-1689
Phone (252) 223-4054

Other identifiers 1

IdentifierTypeStateIssuer
8926870MedicaidNC

Other names 1

  • Newport Dermatology Former legal business name

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/ez_00418

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": "1345420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383091200000",
    "number": "1093063216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1689",
            "city": "NEWPORT",
            "state": "NC",
            "postal_code": "285701689",
            "telephone_number": "252-223-4054",
            "fax_number": "252-223-4216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 HOWARD BLVD",
            "city": "NEWPORT",
            "state": "NC",
            "postal_code": "285707927",
            "telephone_number": "252-223-3405",
            "fax_number": "252-223-4216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWPORT DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-20",
        "last_updated": "2013-10-30",
        "status": "A",
        "authorized_official_last_name": "DANA",
        "authorized_official_first_name": "MAURICE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "252-223-4054",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NC",
            "license": "30120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8926870",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newport Dermatology",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Newport, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.