Organization Active NPI

Rockingham Dermatology, P.C.

  • Dermatology Physician
  • Harrisonburg, VA
National Provider Identifier
1215913314
Registry record updated Oct 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
0101057474 Issued in VA
Legal business name
ROCKINGHAM DERMATOLOGY, P.C.
Practice address
2061 Evelyn Byrd Ave Ste C
Harrisonburg, VA 22801-3442
Phone
(540) 442-8056
Fax
(540) 442-8022
NPI assigned
Dec 20, 2005
Last updated
Oct 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2017

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

Authorized official

Name
Carolyn Ilene Miller, MDNPI 1144206236
Title
President
Phone
(540) 442-8056

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 0101057474 VA Primary

Addresses

Primary practice location

2061 Evelyn Byrd Ave Ste C
Harrisonburg, VA 22801-3442

Mailing address

2061 Evelyn Byrd Ave Ste C
Harrisonburg, VA 22801-3442
Phone (540) 442-8056

Other practice location 1

2061 Evelyn Byrd Ave Ste C
Harrisonburg, VA 22801-3442
Phone (540) 442-8056

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050630000503 VA Part B Supplier - Clinic/Group Practice 3971549858 Receives reassigned benefits from 1 practitioner
Practice locations: Harrisonburg, VA

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
49D0949251Rockingham Dermatology2061 Evelyn Byrd Avenue - Suite C, Harrisonburg, VA 22801ComplianceOct 21, 2026

National Provider Directory

National Provider Directory

Locations

2061 Evelyn Byrd Ave
Ste C
Harrisonburg, VA 22801
Phone (540) 442-8056

Practitioners & affiliated clinicians

Practitioners 2

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": "1135036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506988800000",
    "number": "1215913314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2061 EVELYN BYRD AVE STE C",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228013442",
            "telephone_number": "540-442-8056",
            "fax_number": "540-442-8022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2061 EVELYN BYRD AVE STE C",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228013442",
            "telephone_number": "540-442-8056",
            "fax_number": "540-442-8022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2061 Evelyn Byrd Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Harrisonburg",
            "state": "VA",
            "postal_code": "228013442",
            "country_code": "US",
            "telephone_number": "540-442-8056",
            "fax_number": "540-442-8022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROCKINGHAM DERMATOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-20",
        "last_updated": "2017-10-03",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "ILENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "540-442-8056",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101057474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisonburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2017; 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.