Clemmons Dermatology
Organization Active NPI Dermatology Physician · Clemmons, NC
NPI 1295579555 · NPPES record last updated Jul 24, 2025
Key facts
- NPI
- 1295579555
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- Legal business name
- CLEMMONS DERMATOLOGY
- Practice address
- 2515 Lewisville Clemmons Rd
Clemmons, NC 27012-8712 - Phone
- (336) 416-4093
- NPI assigned
- Jun 21, 2024
- Organization subpart
- No
Authorized official
- Name
- Beth Ann Gurley
- Title
- Physician Assistant
- Phone
- (336) 979-4499
Practitioners 2
-
Beth Gurley, PA-C
-
Christian Scott Gurley, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241210000940 | NC | Part B Supplier - Clinic/Group Practice | 5395271639 |
Receives reassigned benefits from 2 practitioners Practice locations: Clemmons, NC |
National Provider Directory
Locations
2515 Lewisville Clemmons Rd
#R
Clemmons, NC 27012
Phone (336) 416-4093
2515 Lewisville Clemmons Rd
Clemmons, NC 27012
Phone (336) 416-4093
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | Yes | ||
| Clinic/Center | 261Q00000X |
Addresses
Primary practice location
2515 Lewisville Clemmons Rd
Clemmons, NC 27012-8712
Mailing address
2515 Lewisville Clemmons Rd
Clemmons, NC 27012-8712
Phone (336) 416-4093
Other providers in Clemmons, NC
- Bradley Walton Clark
- Joanne Clarkin Gonzalez
- Kevin Joseph Cleary
- Alyssa Laura Clements
- Clemmons Assisted Living LLC
- Clemmons Family Eye Care
- Clemmons Psychiatric Associates
- Clemmons Road Operating Company, LLC
- Clemmons Urgent and Primary Care, PA
- Clemmons Village Chiropractic PLLC
All providers in Clemmons, NC · Dermatology Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.