Dermatology Associates of Coastal Carolina P.a.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY ASSOCIATES OF COASTAL CAROLINA P.A.

Practice address

701 Doctors Dr Ste F
Kinston, NC 28501-1584

Phone

(252) 686-0991

Fax

(252) 686-6810

NPI assigned

Mar 27, 2012

Last updated

Sep 21, 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. James M Polo, MDNPI 1093731168

Title

Owner

Phone

(252) 633-4461

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Dermatology Associates of Coastal Carolina

  • Clinical & Laboratory Dermatological Immunology Physician
  • Morehead City, NC
  • NPI 1023358231

  O20060828000107

  Same enrollment
• Dermatology Associates of Coastal Carolina

  • Clinical & Laboratory Dermatological Immunology Physician
  • Jacksonville, NC
  • NPI 1033459011

  O20060828000107

  Same enrollment
• Dermatology Associates of Coastal Carolina, PA

  • Dermatopathology Physician
  • New Bern, NC
  • NPI 1619903176

  O20060828000107

  Same enrollment

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

CLIA laboratory certificates

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.

• James M Polo, M.D.

  • Dermatology Physician
  • New Bern, NC
  • NPI 1093731168
  Authorized official Same address or phone

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663718400000",
    "number": "1235405960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 890283",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282890283",
            "telephone_number": "252-633-4461",
            "fax_number": "252-633-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DOCTORS DR STE F",
            "city": "KINSTON",
            "state": "NC",
            "postal_code": "285011584",
            "telephone_number": "252-686-0991",
            "fax_number": "252-686-6810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES OF COASTAL CAROLINA P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-27",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A",
        "authorized_official_last_name": "POLO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-633-4461",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Kinston, NC
• Providers in Kinston, 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 Sep 21, 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.