East Tennessee Medical and Surgical Dermatology

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

EAST TENNESSEE MEDICAL AND SURGICAL DERMATOLOGY

Practice address

2898 Boones Creek Rd Ste 105
Johnson City, TN 37615-4976

Phone

(423) 262-0112

NPI assigned

Mar 2, 2020

Last updated

Sep 14, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stuart S LeichtNPI 1013902907

Title

Physician

Phone

(423) 262-0112

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21619/brand/1/csg/1/fhir/r4

Practitioners 1

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.

• Stuart S Leicht, M.D.

  • Dermatology Physician
  • Johnson City, TN
  • NPI 1013902907
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789344000000",
    "number": "1356975106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2898 BOONES CREEK RD STE 105",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154976",
            "telephone_number": "423-262-0112",
            "fax_number": "423-433-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2898 BOONES CREEK RD STE 105",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376154976",
            "telephone_number": "423-262-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TENNESSEE MEDICAL AND SURGICAL DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-02",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A",
        "authorized_official_last_name": "LEICHT",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "423-262-0112"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Tennessee Brain & Spine Center, PC
• East Tennessee Family Care LLC
• East Tennessee Hearing Center
• East Tennessee Hematology-Oncology Assoc (McLeod Cancer and Blood Center Pharmacy)
• East Tennessee Hematology/Oncology Assoc P.C.
• East Tennessee Medical Associates, P.C.
• East Tennessee Neuropathy, PC
• East Tennessee Oncology Partners, LLC
• East Tennessee Recovery, PLLC (New Life Medicine)
• East Tennessee Skilled Care

• Medical Specialty Clinic/Center in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Medical Specialty Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.