NPIMap

Organization Active NPI

Andrus & Associates Dermatology, PA

  • Dermatology Physician
  • Raleigh, NC
National Provider Identifier
1346290590
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
75355 Issued in NC
Legal business name
ANDRUS & ASSOCIATES DERMATOLOGY, PA
Practice address
3809 Computer Dr
Suite 200
Raleigh, NC 27609-6518
Phone
(919) 782-3782
Fax
(919) 782-3788
NPI assigned
May 10, 2006
Last updated
Jul 12, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Authorized official

Name
Thomas Ross Andrus Jr., M.D.NPI 1780653816
Title
President
Phone
(919) 782-3782

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 75355 NC Primary

Addresses

Primary practice location

3809 Computer Dr
Suite 200
Raleigh, NC 27609-6518

Mailing address

3809 Computer Dr
Suite 200
Raleigh, NC 27609-6518
Phone (919) 782-3782

Other identifiers 3

IdentifierTypeStateIssuer
0186JOtherNCNC BLUECROSS BLUESHIELD
152279OtherNCMEDCOST
890186JMedicaidNC

National Provider Directory

National Provider Directory

Locations

3809 Computer Dr
Ste 200
Raleigh, NC 27609
Phone (919) 782-3782

Practitioners & affiliated clinicians

Practitioners 8

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": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184198400000",
    "number": "1346290590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3809 COMPUTER DR",
            "address_2": "SUITE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096518",
            "telephone_number": "919-782-3782",
            "fax_number": "919-782-3788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3809 COMPUTER DR",
            "address_2": "SUITE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096518",
            "telephone_number": "919-782-3782",
            "fax_number": "919-782-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDRUS & ASSOCIATES DERMATOLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2007-07-12",
        "status": "A",
        "authorized_official_last_name": "ANDRUS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "ROSS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-782-3782",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NC",
            "license": "75355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC BLUECROSS BLUESHIELD",
            "identifier": "0186J",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "152279",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890186J",
            "state": "NC"
        }
    ],
    "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 Jul 12, 2007; 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.