Pure Dermatology & Aesthetics, PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

21915 Issued in AL

Legal business name

PURE DERMATOLOGY & AESTHETICS, PC

Practice address

5346 Stadium Trace Pkwy
Suite 100
Hoover, AL 35244-4582

Phone

(205) 682-8022

NPI assigned

Sep 12, 2012

Organization subpart

No

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

Authorized official

Name

Elizabeth Shannon Martin, MDNPI 1942394689

Title

Physician

Phone

(205) 682-8022

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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 4

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

• Elizabeth S. Martin, M.D.

  • Dermatology Physician
  • Hoover, AL
  • NPI 1942394689
  Medicare reassignment Care Compare group NPD Authorized official
• Ross Stuart Hendricks, C.R.N.P.

  • Adult Health Nurse Practitioner
  • Hoover, AL
  • NPI 1902272339
  Medicare reassignment Care Compare group NPD
• Lauren V Robinson, PA-C

  • Surgical Physician Assistant
  • Vestavia HLS, AL
  • NPI 1780245928
  Medicare reassignment Care Compare group
• Chelsi Ganus Davis, PA-C

  • Surgical Physician Assistant
  • Jasper, AL
  • NPI 1225692098
  Medicare reassignment

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347408000000",
    "number": "1104176700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5346 STADIUM TRACE PKWY",
            "address_2": "SUITE 100",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352444582",
            "telephone_number": "205-682-8022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5346 STADIUM TRACE PKWY",
            "address_2": "SUITE 100",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352444582",
            "telephone_number": "205-682-8022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE DERMATOLOGY & AESTHETICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-12",
        "last_updated": "2012-09-12",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "SHANNON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "205-682-8022",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "AL",
            "license": "21915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Publix Alabama LLC
• Publix Alabama, LLC
• Publix Alabama, LLC
• Alexis Ferrell Pugh, DDS, MSD
• Pulmonary Home Healthcare Inc
• Purposed Joy LLC
• Trent Edward Quinn, PHARMD
• Brian Duane Ragland, M.D.
• Farrah Railey
• Marcelo Ramirez, RPH

• Dermatology Physician in Hoover, AL
• Providers in Hoover, AL by specialty
• Dermatology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.