Organization Active NPI

Horizon Dermatology and Skin Surgery Center PLLC

  • Dermatology Physician
  • Soddy Daisy, TN
National Provider Identifier
1285488312
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
HORIZON DERMATOLOGY AND SKIN SURGERY CENTER PLLC
Practice address
10298 Walden St
Soddy Daisy, TN 37379-5152
Phone
(415) 802-1310
Fax
(412) 712-8567
NPI assigned
Apr 15, 2024
Last updated
Jul 31, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Authorized official

Name
Luke Maxfield, MDNPI 1144681255
Title
Owner
Phone
(415) 802-1310

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary
MOHS-Micrographic Surgery Physician 207ND0101X NU

Addresses

Primary practice location

10298 Walden St
Soddy Daisy, TN 37379-5152

Mailing address

10298 Walden St
Soddy Daisy, TN 37379-5152
Phone (415) 802-1310

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240423002304 TN Part B Supplier - Clinic/Group Practice 5799124707 Receives reassigned benefits from 3 practitioners
Practice locations: Soddy Daisy, TN

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
44D2305141Horizon Dermatology and Skin Surgery Center10298 Walden St, Soddy Daisy, TN 37379ComplianceOct 20, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1713139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785456000000",
    "number": "1285488312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10298 WALDEN ST",
            "city": "SODDY DAISY",
            "state": "TN",
            "postal_code": "373795152",
            "telephone_number": "415-802-1310",
            "fax_number": "412-712-8567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10298 WALDEN ST",
            "city": "SODDY DAISY",
            "state": "TN",
            "postal_code": "373795152",
            "telephone_number": "415-802-1310",
            "fax_number": "412-712-8567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HORIZON DERMATOLOGY AND SKIN SURGERY CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-15",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A",
        "authorized_official_last_name": "MAXFIELD",
        "authorized_official_first_name": "LUKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-802-1310",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soddy Daisy, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2026; 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.