Medical & Surgical Dermatology, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

MEDICAL & SURGICAL DERMATOLOGY, LLC

Doing business as

Westgate Dermatology

Practice address

2430 Reidville Rd
Spartanburg, SC 29301-3652

Phone

(904) 664-8644

Fax

(904) 398-7048

NPI assigned

Dec 29, 2023

Organization subpart

Yes

Parent organization

MEDICAL & SURGICAL DERMATOLOGY LLCAs reported in NPPES

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

Authorized official

Name

Peter J Neidenbach, MDNPI 1316905631

Title

President

Phone

(828) 894-2473

Specialties & licenses 1

Addresses

Other names 1

• Westgate Dermatology Doing business as

Part of

Medical Surgical Dermat

Locations

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.

• Peter J Neidenbach, MD

  • Dermatology Physician
  • Columbus, NC
  • NPI 1316905631

  Single Specialty

  NPD Authorized official
• Amy Britain Mitchell, P.A.

  • Physician Assistant
  • Columbus, NC
  • NPI 1174850028
  NPD (past)
• Chad Allan York, PA-C

  • Physician Assistant
  • Columbus, NC
  • NPI 1891074241
  NPD (past)

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

{
    "created_epoch": "1703808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703808000000",
    "number": "1336918408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 HOSPITAL DR STE 3A",
            "city": "COLUMBUS",
            "state": "NC",
            "postal_code": "287228516",
            "telephone_number": "828-894-2473",
            "fax_number": "828-894-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2430 REIDVILLE RD",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293013652",
            "telephone_number": "904-664-8644",
            "fax_number": "904-398-7048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL & SURGICAL DERMATOLOGY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICAL & SURGICAL DERMATOLOGY LLC",
        "enumeration_date": "2023-12-29",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A",
        "authorized_official_last_name": "NEIDENBACH",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "828-894-2473",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westgate Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexis M Mears, OD
• Med-Care Medical Equipment and Supplies
• Med-Trans Corporation
• Medcare Urgent Care Spartanburg, LLC (Medcare Urgent Care)
• Medexpress Primary Care South Carolina, P.C. (Spartanburg Michelin Family Health Center)
• Medical Services of America Inc (Medi Home Care)
• Roxie C Medley, LPC
• Anthony Ty Medlin, PA-C
• Melvin Medlock, MD
• Medq Medical Supply

• Dermatology Physician in Spartanburg, SC
• Providers in Spartanburg, SC by specialty
• Dermatology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.