NPIMap

Organization Active NPI

Heritage Dermatology PC

  • Dermatology Physician
  • Hilton Head Island, SC
National Provider Identifier
1306875950
Registry record updated Mar 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
HERITAGE DERMATOLOGY PC
Practice address
3901 Main St
Suite D
Hilton Head Island, SC 29926-4614
Phone
(843) 689-5259
Fax
(843) 689-3797
NPI assigned
Jul 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2026

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

Authorized official

Name
David Scott Carter
Title
Credentialing Manager
Phone
(630) 590-9250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

3901 Main St
Suite D
Hilton Head Island, SC 29926-4614

Mailing address

PO Box 3821
Bluffton, SC 29910-3821
Phone (843) 689-5259

Other identifiers 1

IdentifierTypeStateIssuer
112194MedicaidSC

Other names 1

  • Dermatology Associates of the Lowcountry Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040202001116 SC Part B Supplier - Clinic/Group Practice 8628961943 Receives reassigned benefits from 7 practitioners
3 other NPIs on this enrollment
Practice locations: Beaufort, SC; Bluffton, SC; Hilton Head, SC

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Locations

242 Ladys Island Dr
Beaufort, SC 29907
Phone (843) 352-6363

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772496000000",
    "number": "1306875950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3821",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299103821",
            "telephone_number": "843-689-5259",
            "fax_number": "843-689-3797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 MAIN ST",
            "address_2": "SUITE D",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299264614",
            "telephone_number": "843-689-5259",
            "fax_number": "843-689-3797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "630-590-9250"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112194",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology Associates of the Lowcountry",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Hilton Head Island, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; 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.