NPIMap

Organization Active NPI

Virginia Dermatology & Skin Cancer Center PLLC

  • Medical Specialty Clinic/Center
  • Norfolk, VA
National Provider Identifier
1396774667
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
0101042937 Issued in VA
Legal business name
VIRGINIA DERMATOLOGY & SKIN CANCER CENTER PLLC
Practice address
9724 Bay Point Dr
Norfolk, VA 23518-2013
Phone
(757) 404-7725
Fax
(757) 362-3577
NPI assigned
Jun 30, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Brian L. Johnson, M.D.NPI 1164495115
Title
President
Phone
(757) 455-5009

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
Medical Specialty Clinic/Center 261QM2500X 0101042937 VA Primary

Addresses

Primary practice location

9724 Bay Point Dr
Norfolk, VA 23518-2013

Mailing address

241 Corporate Blvd
Suite 215
Norfolk, VA 23502-4954
Phone (757) 455-5009

National Provider Directory

National Provider Directory

Locations

241 Corporate Blvd
Ste 215
Norfolk, VA 23502
Phone (757) 455-5009

Practitioners & affiliated clinicians

Practitioners 7

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": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396774667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 CORPORATE BLVD",
            "address_2": "SUITE 215",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235024954",
            "telephone_number": "757-455-5009",
            "fax_number": "757-362-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9724 BAY POINT DR",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235182013",
            "telephone_number": "757-404-7725",
            "fax_number": "757-362-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA DERMATOLOGY & SKIN CANCER CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-455-5009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "VA",
            "license": "0101042937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.