NPIMap

Organization Active NPI

Peninsula Dermatology Skin Cancer Surgery Center, Inc

Doing business as Dermatology Specialists

  • Dermatology Physician
  • Williamsburg, VA
National Provider Identifier
1205993383
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
PENINSULA DERMATOLOGY SKIN CANCER SURGERY CENTER, INC
Doing business as
Dermatology Specialists
Practice address
1601 Commonwealth Ave
Williamsburg, VA 23185-5125
Phone
(757) 259-9466
Fax
(757) 259-7907
NPI assigned
Jan 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Authorized official

Name
Allison Turkovich
Title
Administrator
Phone
(757) 873-0161

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0101X

Addresses

Primary practice location

1601 Commonwealth Ave
Williamsburg, VA 23185-5125

Mailing address

11844 Rock Landing Dr Ste B
Newport News, VA 23606-4202
Phone (757) 873-0161

Other practice location 1

475 McLaws Circle
Suite One
Williamsburg, VA 23185
Phone (757) 259-9466

Other names 1

  • Dermatology Specialists Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D0959143Peninsula Dermatology Skin Cancer Surgery Center1601 Commonwealth Ave, Williamsburg, VA 23185ComplianceJun 7, 2027

National Provider Directory

National Provider Directory
Tax ID family
Dermatology Specialists2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

475 McLaws Cir
Ste 1
Williamsburg, VA 23185
Phone (757) 259-9466

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1205993383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11844 ROCK LANDING DR STE B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064202",
            "telephone_number": "757-873-0161",
            "fax_number": "757-873-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 COMMONWEALTH AVE",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231855125",
            "telephone_number": "757-259-9466",
            "fax_number": "757-259-7907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "475 McLaws Circle",
            "address_2": "Suite One",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "VA",
            "postal_code": "23185",
            "country_code": "US",
            "telephone_number": "757-259-9466",
            "fax_number": "757-259-7907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PENINSULA DERMATOLOGY SKIN CANCER SURGERY CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "TURKOVICH",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "757-873-0161"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williamsburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.