NPIMap

Organization Active NPI

Nashville Skin and Cancer, PLC

Doing business as Nashville Skin Comprehensive Dermatology Center

  • Dermatology Physician
  • Nashville, TN
National Provider Identifier
1497700231
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
NASHVILLE SKIN AND CANCER, PLC
Doing business as
Nashville Skin Comprehensive Dermatology Center
Practice address
2301 21St Ave S
Nashville, TN 37212-4908
Phone
(615) 327-9797
Fax
(615) 613-0329
NPI assigned
May 23, 2006
Last updated
Oct 26, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

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

Authorized official

Name
Luz E Hernandez
Title
Credentialing Specialist
Phone
(615) 327-9797

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X Primary
MOHS-Micrographic Surgery Physician 207ND0101X

Addresses

Primary practice location

2301 21St Ave S
Nashville, TN 37212-4908

Mailing address

2301 21St Ave S
Nashville, TN 37212-4908
Phone (615) 327-9797

Other names 1

  • Nashville Skin Comprehensive Dermatology Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050620000462 TN Part B Supplier - Clinic/Group Practice 2961446026 Receives reassigned benefits from 18 practitioners
Practice locations: Clarksville, TN; Nashville, TN

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D1045493Nashville Skin and Cancer, PLC2301 21St Ave S, 2ND Floor, Nashville, TN 37212ComplianceJan 19, 2028

National Provider Directory

National Provider Directory

Locations

662 Sango Rd
Clarksville, TN 37043
Phone (615) 433-7302

670 Sango Rd
Clarksville, TN 37043
Phone (615) 327-9797

2001 Mallory Ln
Ste 301
Franklin, TN 37067
Phone (615) 771-0134

2301 21st Ave S
Nashville, TN 37212
Phone (615) 305-6871

335 24th Ave N
Ste 520
Nashville, TN 37203

397 Wallace Rd
Ste 402
Nashville, TN 37211

5700 Temple Rd
Ste 201
Nashville, TN 37221
Phone (629) 208-6100

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603670400000",
    "number": "1497700231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 21ST AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372124908",
            "telephone_number": "615-327-9797",
            "fax_number": "615-613-0329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 21ST AVE S",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372124908",
            "telephone_number": "615-327-9797",
            "fax_number": "615-613-0329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NASHVILLE SKIN AND CANCER, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "LUZ",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "615-327-9797"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nashville Skin Comprehensive Dermatology Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; 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.