Individual provider Active NPI

Rebecca L Smith, MD

  • Dermatology Physician
  • Fort Mill, SC
National Provider Identifier
1366412033
Registry record updated Feb 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
15514 Issued in SC
Practice address
1700 First Baxter Xing
Ste 101
Fort Mill, SC 29708-8919
Phone
(803) 802-3376
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NC9901324 NC
Pediatric Dermatology Physician 207NP0225X NC9901324 NC
Pediatric Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207NP0225X 15514 SC
Dermatology Physician 207N00000X 15514 SC Primary

Addresses

Primary practice location

1700 First Baxter Xing
Ste 101
Fort Mill, SC 29708-8919

Mailing address

1700 First Baxter Xing
Ste 101
Fort Mill, SC 29708-8919
Phone (803) 802-3376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060908000071 SC Practitioner - Dermatology 6204830136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Baylor College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology of SC PC 32 clinicians

Practice addresses (Care Compare)

1650 Skylyn Dr
Suite 402
Spartanburg, SC 29307-1086
Phone (864) 574-0017

Merit-based Incentive Payment System (MIPS)

Final score
83.24 of 100Reported as group
Quality
80.28
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1410
Removal or shaving of skin growth1-10
Skin biopsy217

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
NC9901324NCMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dermatology of SC PC Single Specialty CurrentSince Nov 1, 2021 Accepting new patients
Carolina Dermatology, LLC Single Specialty PastSince May 18, 1998 Accepting new patients

Locations

1700 1st Baxter Xing
Ste 101
Fort Mill, SC 29708
Phone (803) 802-3376

1650 Skylyn Dr
Ste 402
Spartanburg, SC 29307
Phone (864) 574-0017

3574 Sunset Blvd
West Columbia, SC 29169
Phone (803) 796-2500

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517529600000",
    "number": "1366412033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 FIRST BAXTER XING",
            "address_2": "STE 101",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088919",
            "telephone_number": "803-802-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 FIRST BAXTER XING",
            "address_2": "STE 101",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297088919",
            "telephone_number": "803-802-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "REBECCA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2018-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "NC9901324",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "NC",
            "license": "NC9901324",
            "primary": false
        },
        {
            "code": "207NP0225X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Pediatric Dermatology",
            "state": "SC",
            "license": "15514",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "15514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

Verify at the official NPI Registry.