Active NPI
Carolina Dermatology PA
- Dermatology Physician
- Greenville, SC
National Provider Identifier
1104678085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Legal business name
- CAROLINA DERMATOLOGY PA
- Practice address
- 5 Stevens St Ste 300
Greenville, SC 29605-4528 - Phone
- (864) 233-6338
- Fax
- (864) 235-1982
- NPI assigned
- Apr 3, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Charles Darragh, MD
- Title
- Shareholder
- Phone
- (864) 293-0281
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | Primary | ||
| MOHS-Micrographic Surgery Physician | 207ND0101X |
Addresses
Primary practice location
5 Stevens St Ste 300
Greenville, SC 29605-4528
Mailing address
5 Stevens St Ste 300
Greenville, SC 29605-4528
Phone (864) 233-6338
Other practice location 1
10 Enterprise Blvd Ste 202
Greenville, SC 29615-3554
Phone (864) 233-6338
Other names 1
- Carolina Dermatology of Greenville
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240528001688 | SC | Part B Supplier - Clinic/Group Practice | 8022450659 |
Receives reassigned benefits from 9 practitioners Practice locations: Greenville, SC |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 42D0252325 | Carolina Dermatology, PA | Compliance | Dec 11, 2027 |
| 42D2332011 | Carolina Dermatology, PA | Provider-performed microscopy | Oct 12, 2027 |
National Provider Directory
National Provider DirectoryLocations
5 Stevens St
Ste 300
Greenville, SC 29605
Phone (864) 233-6338
920 Woodruff Rd
Greenville, SC 29607
Phone (864) 233-6332
Practitioners & affiliated clinicians
Practitioners 10
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- MOHS-Micrographic Surgery Physician
- Greenville, SC
- NPI 1245676774
Dermatology, SC
-
- Pediatric Nurse Practitioner
- Greenville, SC
- NPI 1619131893
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712102400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1762732800000",
"number": "1104678085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 STEVENS ST STE 300",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296054528",
"telephone_number": "864-233-6338",
"fax_number": "864-235-1982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 STEVENS ST STE 300",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296054528",
"telephone_number": "864-233-6338",
"fax_number": "864-235-1982"
}
],
"practiceLocations": [
{
"address_1": "10 Enterprise Blvd Ste 202",
"address_purpose": "LOCATION",
"city": "Greenville",
"state": "SC",
"postal_code": "296153554",
"country_code": "US",
"telephone_number": "864-233-6338",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "CAROLINA DERMATOLOGY PA",
"organizational_subpart": "NO",
"enumeration_date": "2024-04-03",
"last_updated": "2025-11-10",
"certification_date": "2025-11-10",
"status": "A",
"authorized_official_last_name": "DARRAGH",
"authorized_official_first_name": "CHARLES",
"authorized_official_title_or_position": "SHAREHOLDER",
"authorized_official_telephone_number": "864-293-0281",
"authorized_official_credential": "MD"
},
"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": [
{
"organization_name": "Carolina Dermatology of Greenville",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Greenville, SC
- Carolina Continence Center, LLC
- Carolina Cornea and Laser Center
- Carolina Dental Alliance of Greenville
- Carolina Dental Group
- Carolina Dermatology of Greenville, PA
- Carolina Ear & Hearing Clinic, PC
- Carolina ENT, PA
- Carolina ENT, PA
- Carolina Family Adult Services LLC
- Carolina Family Orthodontics of Furman, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; 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.