Organization Active NPI

Sunrise Dermatology LLC

  • Dermatology Physician
  • Daphne, AL
National Provider Identifier
1538630751
Registry record updated Feb 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SUNRISE DERMATOLOGY LLC
Doing business as
Sunrise Dermatology
Practice address
8832 US Hwy 90
Daphne, AL 36526
Phone
(251) 289-1786
NPI assigned
Dec 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2019

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

Authorized official

Name
Sarah Wierszalowski
Title
Administrator
Phone
(251) 544-6407

Specialties & licenses 1

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

Addresses

Primary practice location

8832 US Hwy 90
Daphne, AL 36526

Mailing address

70 Midtown Park E
Mobile, AL 36606-4140
Phone (251) 544-6407

Other names 1

  • Sunrise Dermatology Doing business as

National Provider Directory

National Provider Directory

Locations

14634 Saint Stephens Ave
Chatom, AL 36518
Phone (251) 847-3077

NPI Registry JSON

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549497600000",
    "number": "1538630751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 MIDTOWN PARK E",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366064140",
            "telephone_number": "251-544-6407",
            "fax_number": "251-544-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8832 US HWY 90",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "36526",
            "telephone_number": "251-289-1786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-16",
        "last_updated": "2019-02-07",
        "status": "A",
        "authorized_official_last_name": "WIERSZALOWSKI",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "251-544-6407"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunrise Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Daphne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.