NPIMap

Organization Active NPI

Dermatology & Laser Center of Chapel Hill, PLLC

  • Dermatology Physician
  • Chapel Hill, NC
National Provider Identifier
1114470523
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DERMATOLOGY & LASER CENTER OF CHAPEL HILL, PLLC
Practice address
58 Chapelton Court
Suite 120
Chapel Hill, NC 27516
Phone
(919) 949-7838
NPI assigned
Aug 2, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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

Authorized official

Name
Ms. Christine Myers
Title
Credentialing Specialist
Phone
(919) 442-0447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

58 Chapelton Court
Suite 120
Chapel Hill, NC 27516

Mailing address

58 Chapelton Court
Suite 120
Chapel Hill, NC 27516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160929000283 NC Part B Supplier - Clinic/Group Practice 9436446838 Receives reassigned benefits from 6 practitioners
Practice locations: Chapel Hill, NC

National Provider Directory

National Provider Directory

Locations

58 Chapelton Ct
Ste 120
Chapel Hill, NC 27516
Phone (919) 942-2922

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470096000000",
    "number": "1114470523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 CHAPELTON COURT",
            "address_2": "SUITE 120",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "27516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 CHAPELTON COURT",
            "address_2": "SUITE 120",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "27516",
            "telephone_number": "919-949-7838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY & LASER CENTER OF CHAPEL HILL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-02",
        "last_updated": "2016-08-02",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "919-442-0447",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.