Individual provider Active NPI

Marc Ronald Carruth, M.D.

  • MOHS-Micrographic Surgery Physician
  • Charlotte, NC
National Provider Identifier
1528035722
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
9700501 Issued in NC
Practice address
2615 E 7TH St
Charlotte, NC 28204-4376
Phone
(704) 295-0000
Fax
(704) 295-0005
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 9700501 NC Primary

Addresses

Primary practice location

2615 E 7TH St
Charlotte, NC 28204-4376

Mailing address

2615 E 7TH St
Charlotte, NC 28204-4376
Phone (704) 295-0000

Other practice location 1

13539 Reese Blvd W
Huntersville, NC 28078-7961
Phone (704) 892-4878

Other practice location 2

7476 Waterside Loop Rd
Denver, NC 28037-7679
Phone (704) 601-4381

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20100709000388 NC Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 2466451208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
89.65 of 100Reported as group
Quality
91.92
Promoting interoperability
94
Improvement activities
40
Cost
78.58

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Plastic Surgery & Dermatology PA CurrentSince Oct 15, 2022 Accepting new patients
Piedmont Plastic Surgery and Dermatology Past Accepting new patients

Locations

2615 E 7th St
Charlotte, NC 28204
Phone (704) 295-0000

19900 W Catawba Ave
Ste B
Cornelius, NC 28031
Phone 7046711094101

1072 X Ray Dr
Gastonia, NC 28054
Phone (704) 671-1094

959 Cox Rd
Gastonia, NC 28054
Phone (704) 866-0106

13539 Reese Blvd W
Huntersville, NC 28078
Phone (704) 892-4878

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": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1528035722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 E 7TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044376",
            "telephone_number": "704-295-0000",
            "fax_number": "704-295-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 E 7TH ST",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282044376",
            "telephone_number": "704-295-0000",
            "fax_number": "704-295-0005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13539 Reese Blvd W",
            "address_purpose": "LOCATION",
            "city": "Huntersville",
            "state": "NC",
            "postal_code": "280787961",
            "country_code": "US",
            "telephone_number": "704-892-4878",
            "fax_number": "704-892-7453",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7476 Waterside Loop Rd",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "NC",
            "postal_code": "280377679",
            "country_code": "US",
            "telephone_number": "704-601-4381",
            "fax_number": "704-822-5997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARRUTH",
        "first_name": "MARC",
        "middle_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NC",
            "license": "9700501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.