Piedmont Dermatology Center, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101228761 Issued in VA

Legal business name

PIEDMONT DERMATOLOGY CENTER, PC

Practice address

314 Fairy Street Ext
Suite D
Martinsville, VA 24112-1913

Phone

(276) 666-8439

Fax

(276) 666-8440

NPI assigned

Oct 18, 2006

Last updated

Oct 3, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ned Jay Gross, M.D.NPI 1346229127

Title

President/Medical Doctor

Phone

(276) 666-8439

Specialties & licenses 1

Addresses

Other identifiers 12

Medicare fee-for-service enrollment

Enrolled in VA

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 5

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.

• Ned Jay Gross, M.D.

  • Dermatology Physician
  • Martinsville, VA
  • NPI 1346229127
  Medicare reassignment Care Compare group NPD Authorized official
• Ankit Agarwal, M.D.

  • Radiation Oncology Physician
  • San Antonio, TX
  • NPI 1629430376

  VA

  Medicare reassignment Care Compare group NPD
• Janet Lauren Zampich, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Danville, VA
  • NPI 1194884429
  NPD (past)
• Jennifer R Clark-Bruning, PAC

  • Medical Physician Assistant
  • Greensboro, NC
  • NPI 1699847921
  NPD (past)
• Paul Douglass Wortman, M.D.

  • Dermatology Physician
  • Winston Salem, NC
  • NPI 1932108461
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317600000000",
    "number": "1538240486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 FAIRY STREET EXT",
            "address_2": "SUITE D",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241121913",
            "telephone_number": "276-666-8439",
            "fax_number": "276-666-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 FAIRY STREET EXT",
            "address_2": "SUITE D",
            "city": "MARTINSVILLE",
            "state": "VA",
            "postal_code": "241121913",
            "telephone_number": "276-666-8439",
            "fax_number": "276-666-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIEDMONT DERMATOLOGY CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2011-10-03",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "NED",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT/MEDICAL DOCTOR",
        "authorized_official_telephone_number": "276-666-8439",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101228761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "070015390",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9767433",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "285584",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89011P5",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7986163",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "A1547",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0308562",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "A1547",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "011P5",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "070015616",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7986163",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9767433",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krystal Inman Phillips, FNP-C
• Phoenix Home Care of Virginia
• Physician Management Services of Virginia II, LLC
• Piedmont Access to Health Services, Inc (PATHS Community Pharmacy)
• Piedmont Access to Health Services, Inc (Health Center of the Piedmont Martinsville)
• Piedmont Diagnostic Radiology PC
• Piedmont Medical and Renal Associates
• Piedmont Podiatry Associates (Piedmont Foot Center)
• Piedmont Regional Community Services Board (Piedmont Home)
• Piedmont Regional Community Services Board (Piedmont CSB Transportation)

• Specialist in Martinsville, VA
• Providers in Martinsville, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; 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.