Organization Active NPI

Steelecreek Dermatology PLLC

  • Dermatology Physician
  • Charlotte, NC
National Provider Identifier
1447597752
Registry record updated Sep 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
94-00526 Issued in NC
Legal business name
STEELECREEK DERMATOLOGY PLLC
Practice address
13557 Steelecroft Pkwy
Suite 2500
Charlotte, NC 28278-7550
Phone
(704) 587-3200
Fax
(704) 587-0044
NPI assigned
Jan 7, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2013

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

Authorized official

Name
Jennifer L Helton, M.D.NPI 1619947462
Title
President
Phone
(704) 587-3200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 94-00526 NC Primary

Addresses

Primary practice location

13557 Steelecroft Pkwy
Suite 2500
Charlotte, NC 28278-7550

Mailing address

13557 Steelecroft Pkwy
Suite 2500
Charlotte, NC 28278-7550
Phone (704) 587-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130429000567 NC Part B Supplier - Clinic/Group Practice 2466698923 Receives reassigned benefits from 4 practitioners
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Locations

13557 Steelecroft Pkwy
Ste 2500
Charlotte, NC 28278
Phone (704) 587-3200

11040 S Tryon St
Ste 203
Charlotte, NC 28273
Phone (704) 587-3200

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378080000000",
    "number": "1447597752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13557 STEELECROFT PKWY",
            "address_2": "SUITE 2500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282787550",
            "telephone_number": "704-587-3200",
            "fax_number": "704-587-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13557 STEELECROFT PKWY",
            "address_2": "SUITE 2500",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282787550",
            "telephone_number": "704-587-3200",
            "fax_number": "704-587-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEELECREEK DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-07",
        "last_updated": "2013-09-02",
        "status": "A",
        "authorized_official_last_name": "HELTON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-587-3200",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NC",
            "license": "94-00526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2013; 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.