Rock Hill Dermatology Center

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

ROCK HILL DERMATOLOGY CENTER

Practice address

1533 Ebenezer Rd
Rock Hill, SC 29732-1806

Phone

(803) 328-1831

Fax

(803) 328-0283

NPI assigned

Mar 11, 2008

Organization subpart

No

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

Authorized official

Name

Oz Idlibi

Title

Administrator

Phone

(803) 393-3710

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Darin Gray, PA

  • Medical Physician Assistant
  • Rock Hill, SC
  • NPI 1619325990
  Medicare reassignment Care Compare group
• Alaina Geiss, PA-C

  • Medical Physician Assistant
  • Pinehurst, NC
  • NPI 1588377378

  SC

  Medicare reassignment Care Compare group
• Eugene M Lepine, MD

  • Dermatology Physician
  • Rock Hill, SC
  • NPI 1508864927

  Specialist

  Medicare reassignment NPD
• Sanaya Gandhi, PA

  • Physician Assistant
  • Charlotte, NC
  • NPI 1891385548

  SC

  Medicare reassignment
• Mallory Ann Hoskins, PA

  • Physician Assistant
  • Charlotte, NC
  • NPI 1811550197

  SC

  Medicare reassignment
• Laura Elizabeth Kiely, PA

  • Physician Assistant
  • Lakewood Ranch, FL
  • NPI 1063831899

  SC

  Medicare reassignment

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668384000000",
    "number": "1447420070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 EBENEZER RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321806",
            "telephone_number": "803-328-1831",
            "fax_number": "803-324-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1533 EBENEZER RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321806",
            "telephone_number": "803-328-1831",
            "fax_number": "803-328-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK HILL DERMATOLOGY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A",
        "authorized_official_last_name": "IDLIBI",
        "authorized_official_first_name": "OZ",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "803-393-3710"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "SC",
            "license": "06954",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Robinson, LCMHC, LPC
• Zarionna Robinson
• Kelly Rocheleau, MPT
• Rock Hill Behavioral, LLC
• Rock Hill Chiropractic Works Inc.
• Rock Hill Eye Clinic, P.a.
• Rock Hill Eye Clinic, PA
• Rock Hill Gynecological and Obstetrical Associates, PA
• Rock Hill Healthcare LLC
• Rock Hill Medserve LLC

• Dermatology Physician in Rock Hill, SC
• Providers in Rock Hill, 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 Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.