Carolina Dermatology, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

CAROLINA DERMATOLOGY, LLC

Practice address

10502 Park Rd
Suite 100
Charlotte, NC 28210-8479

Phone

(704) 542-1366

Fax

(704) 542-1063

NPI assigned

Apr 5, 2006

Organization subpart

No

Name

Gerald Earl Cooley, M.D.

Title

President/Owner

Phone

(704) 542-1366

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

• Deborah Gardner Nixon, MD

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1073575684

  Dermatology

  NPD (past)
• Rebecca L Smith, MD

  • Dermatology Physician
  • Fort Mill, SC
  • NPI 1366412033

  Single Specialty

  NPD (past)

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 1, 2008.

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1144282930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10502 PARK RD",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108479",
            "telephone_number": "704-542-1366",
            "fax_number": "704-542-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10502 PARK RD",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108479",
            "telephone_number": "704-542-1366",
            "fax_number": "704-542-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-05",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "COOLEY",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "EARL",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "704-542-1366",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC GROUP #",
            "identifier": "0212C",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolina Compound, LLC
• Carolina Concierge Therapeutics, PLLC
• Carolina Counseling Co PLLC
• Carolina Counseling Group, LLC
• Carolina Cross Connection, Inc
• Carolina Diagnostics, Inc
• Carolina Digestive Health Associates, PA
• Carolina Digestive Health Associates, PA
• Carolina Disc Associates, P.C.
• Carolina Ear, Nose & Throat Head and Neck Surgery Center, P.a.

• All providers in Charlotte, NC
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.