NPIMap

Organization Active NPI

Beckley Dermatology Inc.

  • Dermatology Physician
  • Williamson, WV
National Provider Identifier
1568076180
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
BECKLEY DERMATOLOGY INC.
Practice address
150 E 2ND Ave
Williamson, WV 25661-3602
Phone
(304) 235-5780
Fax
(304) 235-5799
NPI assigned
Sep 1, 2020
Last updated
Sep 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Authorized official

Name
Dr. Nelson E. Velazquez, DONPI 1730189747
Title
Sole Owner
Phone
(304) 252-2673

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary
MOHS-Micrographic Surgery Physician 207ND0101X NU
Dermatopathology Physician 207ND0900X NU

Addresses

Primary practice location

150 E 2ND Ave
Williamson, WV 25661-3602

Mailing address

136 Linden Dr Ste 104
Winchester, VA 22601-6900
Phone (406) 783-5885

National Provider Directory

National Provider Directory
Tax ID family
Beckley Dermatology Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598918400000",
    "number": "1568076180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 LINDEN DR STE 104",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226016900",
            "telephone_number": "406-783-5885",
            "fax_number": "540-678-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E 2ND AVE",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256613602",
            "telephone_number": "304-235-5780",
            "fax_number": "304-235-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BECKLEY DERMATOLOGY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A",
        "authorized_official_last_name": "VELAZQUEZ",
        "authorized_official_first_name": "NELSON",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "304-252-2673",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamson, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.