Organization Active NPI

Highlands Dermatology PA

  • Dermatology Physician
  • Highlands, NC
National Provider Identifier
1235531906
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
203895 Issued in NC
Legal business name
HIGHLANDS DERMATOLOGY PA
Practice address
209 Hospital Dr
Suite 302
Highlands, NC 28741-7623
Phone
(828) 526-1232
Fax
(828) 526-9988
NPI assigned
Sep 24, 2014
Last updated
Sep 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

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

Authorized official

Name
Mr. Kelly Joseph Tandy
Title
Office Manager
Phone
(828) 526-1232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 203895 NC Primary

Addresses

Primary practice location

209 Hospital Dr
Suite 302
Highlands, NC 28741-7623

Mailing address

209 Hospital Dr
Suite 302
Highlands, NC 28741-7623
Phone (828) 526-1232

Other names 1

  • Paul S Cabiran Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141205001450 NC Part B Supplier - Clinic/Group Practice 7416279229 Receives reassigned benefits from 7 practitioners
Practice locations: Brevard, NC; Franklin, NC; Highlands, NC

National Provider Directory

National Provider Directory

Locations

29 W French Broad St
Ste 204
Brevard, NC 28712
Phone (888) 245-5337

29 W French Broad St
Ste 205
Brevard, NC 28712
Phone (828) 526-1232

118 Holly Springs Park Dr
Franklin, NC 28734
Phone (828) 349-1551

209 Hospital Dr
Ste 302
Highlands, NC 28741
Phone (828) 526-1232

Practitioners & affiliated clinicians

Practitioners 7

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": "1411516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411516800000",
    "number": "1235531906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 HOSPITAL DR",
            "address_2": "SUITE 302",
            "city": "HIGHLANDS",
            "state": "NC",
            "postal_code": "287417623",
            "telephone_number": "828-526-1232",
            "fax_number": "828-526-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 HOSPITAL DR",
            "address_2": "SUITE 302",
            "city": "HIGHLANDS",
            "state": "NC",
            "postal_code": "287417623",
            "telephone_number": "828-526-1232",
            "fax_number": "828-526-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLANDS DERMATOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-24",
        "last_updated": "2014-09-24",
        "status": "A",
        "authorized_official_last_name": "TANDY",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "828-526-1232",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "203895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paul S Cabiran",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Highlands, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; 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.