NPIMap

Organization Active NPI

Pinehurst Skin Surgery Center PLLC

  • Clinical & Laboratory Dermatological Immunology Physician
  • Pinehurst, NC
National Provider Identifier
1235324344
Registry record updated Jul 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical & Laboratory Dermatological Immunology PhysicianTaxonomy code 207NI0002X
License
38791 Issued in NC
Legal business name
PINEHURST SKIN SURGERY CENTER PLLC
Practice address
289 Olmsted Blvd
Suite 5
Pinehurst, NC 28374-8729
Phone
(910) 295-2945
Fax
(910) 295-2937
NPI assigned
Sep 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2012

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

Authorized official

Name
Dr. Candace Williamson King, M.D.
Title
Physician
Phone
(910) 295-2945

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0101X 38791 NC
Clinical & Laboratory Dermatological Immunology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207NI0002X 38791 NC Primary
Procedural Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207NS0135X 38791 NC

Addresses

Primary practice location

289 Olmsted Blvd
Suite 5
Pinehurst, NC 28374-8729

Mailing address

289 Olmsted Blvd
Suite 5
Pinehurst, NC 28374-8729
Phone (910) 295-2945

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342051200000",
    "number": "1235324344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "289 OLMSTED BLVD",
            "address_2": "SUITE 5",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748729",
            "telephone_number": "910-295-2945",
            "fax_number": "910-295-2937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 OLMSTED BLVD",
            "address_2": "SUITE 5",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748729",
            "telephone_number": "910-295-2945",
            "fax_number": "910-295-2937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEHURST SKIN SURGERY CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2012-07-12",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_middle_name": "WILLIAMSON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "910-295-2945",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NC",
            "license": "38791",
            "primary": false
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "NC",
            "license": "38791",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NC",
            "license": "38791",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; 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.