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

Last updated

May 1, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gerald Earl Cooley, M.D.NPI 1679543300

Title

President/Owner

Phone

(704) 542-1366

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Gerald Cooley, M.D.

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1679543300
  Authorized official Same address or phone
• Deborah Gardner Nixon, MD

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1073575684
  NPD (past)
• Rebecca L Smith, MD

  • Dermatology Physician
  • Fort Mill, SC
  • NPI 1366412033

  Single Specialty

  NPD (past)

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

{
    "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": [],
    "endpoints": [],
    "other_names": []
}

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

• Dermatology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• 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.