NPIMap

Organization Active NPI

Raleigh Dermatology Associates PA

  • Dermatology Physician
  • Raleigh, NC
National Provider Identifier
1285674952
Registry record updated Nov 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
RALEIGH DERMATOLOGY ASSOCIATES PA
Practice address
800 Springfield Commons Dr
Suite 115
Raleigh, NC 27609-8533
Phone
(919) 876-3656
Fax
(919) 876-2351
NPI assigned
Jun 8, 2006
Last updated
Nov 7, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2011

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

Authorized official

Name
Fernando R Puente, MDNPI 1598741894
Title
Owner
Phone
(919) 876-3656

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

800 Springfield Commons Dr
Suite 115
Raleigh, NC 27609-8533

Mailing address

800 Springfield Commons Dr
Suite 115
Raleigh, NC 27609-8533
Phone (919) 876-3656

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
34D0240607Raleigh Dermatology Associates800 Springfield Commons Drive, Suite 115, Raleigh, NC 27609ComplianceAug 17, 2027

National Provider Directory

National Provider Directory

Locations

800 Springfield Commons Dr
Ste 115
Raleigh, NC 27609
Phone (919) 876-3656

Interoperability endpoints

  • Direct secure messaging: fernandopuente@rd.allscriptsdirect.net
  • Direct secure messaging: gingeratkinson@rd.allscriptsdirect.net
  • Direct secure messaging: lisaharewood@rd.allscriptsdirect.net
  • Direct secure messaging: michaelkeene@rd.allscriptsdirect.net
  • Direct secure messaging: steffanyshearer@rd.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320624000000",
    "number": "1285674952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SPRINGFIELD COMMONS DR",
            "address_2": "SUITE 115",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276098533",
            "telephone_number": "919-876-3656",
            "fax_number": "919-876-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRINGFIELD COMMONS DR",
            "address_2": "SUITE 115",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276098533",
            "telephone_number": "919-876-3656",
            "fax_number": "919-876-2351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALEIGH DERMATOLOGY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2011-11-07",
        "status": "A",
        "authorized_official_last_name": "PUENTE",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-876-3656",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.