Organization Active NPI

Dermatology and Laser Center of Charleston PA

  • Dermatology Physician
  • Charleston, SC
National Provider Identifier
1124198361
Registry record updated Apr 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DERMATOLOGY AND LASER CENTER OF CHARLESTON PA
Practice address
2180 Henry Tecklenburg Dr
Charleston, SC 29414-5798
Phone
(843) 556-8886
Fax
(843) 556-8850
NPI assigned
Nov 8, 2006
Last updated
Apr 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2015

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

Authorized official

Name
Dr. Todd E Schlesinger, M.D.NPI 1538135280
Title
Physician
Phone
(843) 556-8886

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

2180 Henry Tecklenburg Dr
Charleston, SC 29414-5798

Mailing address

2180 Henry Tecklenburg Drive
Charleston, SC 29414-5741
Phone (843) 556-8886

Other identifiers 1

IdentifierTypeStateIssuer
8276OtherSCPTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050707000638 SC Part B Supplier - Clinic/Group Practice 8527004902 Receives reassigned benefits from 11 practitioners
Practice locations: Charleston, SC

National Provider Directory

National Provider Directory

Locations

2093 Henry Tecklenburg Dr
Ste 300
Charleston, SC 29414
Phone (843) 556-8886

2180 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 556-8886

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429833600000",
    "number": "1124198361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 HENRY TECKLENBURG DRIVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145741",
            "telephone_number": "843-556-8886",
            "fax_number": "843-556-8850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294145798",
            "telephone_number": "843-556-8886",
            "fax_number": "843-556-8850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY AND LASER CENTER OF CHARLESTON PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2015-04-24",
        "status": "A",
        "authorized_official_last_name": "SCHLESINGER",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "843-556-8886",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "8276",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; 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.