Medical & Surgical Dermatology, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

66555 Issued in NC

Legal business name

MEDICAL & SURGICAL DERMATOLOGY, LLC

Doing business as

Westgate Dermatology

Practice address

55 Palmer Jervey Dr Ste B
Columbus, NC 28722-0580

Phone

(828) 894-2473

Fax

(828) 894-2390

NPI assigned

Apr 20, 2007

Last updated

Jul 10, 2025By 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. Peter J Neidenbach, M.D.NPI 1316905631

Title

Physician

Phone

(828) 894-2473

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Westgate Dermatology Doing business as

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

Enrollment records 2

Locations

Practitioners 4

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.

• Peter J Neidenbach, MD

  • Dermatology Physician
  • Columbus, NC
  • NPI 1316905631

  SC, Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Amy Britain Mitchell, P.A.

  • Physician Assistant
  • Columbus, NC
  • NPI 1174850028

  SC

  Medicare reassignment Care Compare group
• Chad Allan York, PA-C

  • Physician Assistant
  • Columbus, NC
  • NPI 1891074241

  SC

  Medicare reassignment Care Compare group
• Jessica Ann Mills, PAC

  • Physician Assistant
  • Spartanburg, SC
  • NPI 1477611945
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752105600000",
    "number": "1619194404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 HOSPITAL DR STE 3A",
            "city": "COLUMBUS",
            "state": "NC",
            "postal_code": "287228516",
            "telephone_number": "828-894-2473",
            "fax_number": "828-894-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 PALMER JERVEY DR STE B",
            "city": "COLUMBUS",
            "state": "NC",
            "postal_code": "287220580",
            "telephone_number": "828-894-2473",
            "fax_number": "828-894-2390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2430 Reidville Rd",
            "address_purpose": "LOCATION",
            "city": "Spartanburg",
            "state": "SC",
            "postal_code": "293013652",
            "country_code": "US",
            "telephone_number": "904-664-8644",
            "fax_number": "904-398-7048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDICAL & SURGICAL DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A",
        "authorized_official_last_name": "NEIDENBACH",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "828-894-2473",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NC",
            "license": "66555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2336482",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "9501356",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MMM.16384MD",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westgate Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Westgate Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cameron Meadow Martin, PA
• Ramses Carlos Masis, MD
• Michelle McClendon, O.T.
• Shannon McCool, M.S. CCC-SLP
• John Scott McDermott
• Peter Jerome Mehr, DDS
• Chandler Miller, PT
• Jessica Jo Miller, FNP-C
• Brett Mills
• Lester Roscoe Minish Jr., PTA

• Dermatology Physician in Columbus, NC
• Providers in Columbus, NC by specialty
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.