Organization Active NPI

Auburn Dermatology and Skin Cancer Center

  • Dermatology Physician
  • Auburn, AL
National Provider Identifier
1215029053
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
AUBURN DERMATOLOGY AND SKIN CANCER CENTER
Practice address
785 N Dean Rd Ste 400
Auburn, AL 36830-4034
Phone
(334) 887-5060
Fax
(334) 887-4367
NPI assigned
Sep 29, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Patty May
Title
Billing Manager
Phone
(334) 887-5060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X Primary

Addresses

Primary practice location

785 N Dean Rd Ste 400
Auburn, AL 36830-4034

Mailing address

785 N Dean Rd Ste 400
Auburn, AL 36830-4034
Phone (334) 887-5060

Other identifiers 1

IdentifierTypeStateIssuer
J950OtherALMEDICARE PROVIDER NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040811001039 AL Part B Supplier - Clinic/Group Practice 0648242420 Receives reassigned benefits from 1 practitioner
Practice locations: Auburn, AL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1215029053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 N DEAN RD STE 400",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368304034",
            "telephone_number": "334-887-5060",
            "fax_number": "334-887-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 N DEAN RD STE 400",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368304034",
            "telephone_number": "334-887-5060",
            "fax_number": "334-887-4367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUBURN DERMATOLOGY AND SKIN CANCER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MAY",
        "authorized_official_first_name": "PATTY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "334-887-5060"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "J950",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.