Midtown Dermatology, PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

203528 Issued in NC

Legal business name

MIDTOWN DERMATOLOGY, PC

Practice address

5904 Six Forks Rd Ste 211
Raleigh, NC 27609-8228

Phone

(984) 242-0510

Fax

(984) 242-0520

NPI assigned

Jul 9, 2014

Last updated

Nov 16, 2022By 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

Dr. Beth Anne Schulz-Butulis, DONPI 1134165830

Title

President

Phone

(984) 242-0510

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 9

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.

• Beth Anne Schulz-Butulis, D.O.

  • Dermatology Physician
  • Raleigh, NC
  • NPI 1134165830
  Medicare reassignment Care Compare group NPD Authorized official
• Alexandra Hryniewicki, PA-C

  • Physician Assistant
  • Cary, NC
  • NPI 1689456881
  Medicare reassignment Care Compare group NPD
• Sandrivette Johnson, FNP-C

  • Nurse Practitioner
  • Raleigh, NC
  • NPI 1740201458
  Medicare reassignment Care Compare group NPD
• Sarah Ashlyn Djali Purvis, PA-C

  • Physician Assistant
  • Raleigh, NC
  • NPI 1225532666
  Medicare reassignment Care Compare group
• Jaclyn Rhea Schavone, PA-C

  • Physician Assistant
  • Raleigh, NC
  • NPI 1407453921
  Medicare reassignment Care Compare group
• Richard Edward Babb, PA-C

  • Surgical Physician Assistant
  • Raleigh, NC
  • NPI 1851539993
  NPD (past)
• William Neil Boykin, FNP-BC

  • Family Nurse Practitioner
  • Cary, NC
  • NPI 1548599244
  NPD (past)
• Steven Migdon, PA-C

  • Medical Physician Assistant
  • Rocky Mount, NC
  • NPI 1669432639
  NPD (past)
• Raymond Michael Baule, MD

  • Neurological Surgery Physician
  • West Islip, NY
  • NPI 1962619023
  NPD (past)

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

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668556800000",
    "number": "1205242252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5904 SIX FORKS RD STE 211",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276098228",
            "telephone_number": "984-242-0510",
            "fax_number": "984-242-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5904 SIX FORKS RD STE 211",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276098228",
            "telephone_number": "984-242-0510",
            "fax_number": "984-242-0520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4056 Capital Dr",
            "address_purpose": "LOCATION",
            "city": "Rocky Mount",
            "state": "NC",
            "postal_code": "278043123",
            "country_code": "US",
            "telephone_number": "984-242-0510",
            "fax_number": "984-242-0520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDTOWN DERMATOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-09",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A",
        "authorized_official_last_name": "SCHULZ-BUTULIS",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "984-242-0510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "203528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "DV9975",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "D895",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Midtown Chiropractic Clinic PLLC
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• Marcia Garris Miedema, PA-C
• Mighty Men of Valoroutreach
• Mighty Mindful Wellness

• Dermatology Physician in Raleigh, NC
• Providers in Raleigh, 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 Nov 16, 2022; 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.

Verify at the official NPI Registry.