NPIMap

Organization Active NPI

Metrolina Dermatology and Skin Surgery Specialists, PLLC

  • Dermatology Physician
  • Charlotte, NC
National Provider Identifier
1619400033
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
METROLINA DERMATOLOGY AND SKIN SURGERY SPECIALISTS, PLLC
Practice address
10502 Park Rd
Charlotte, NC 28210-8479
Phone
(937) 433-7536
NPI assigned
Apr 4, 2017
Last updated
Mar 30, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Authorized official

Name
Eugene Brent Kirkland, MDNPI 1255580171
Title
Cmo
Phone
(937) 312-3820

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 Primary
MOHS-Micrographic Surgery Physician 207ND0101X
Dermatopathology Physician 207ND0900X

Addresses

Primary practice location

10502 Park Rd
Charlotte, NC 28210-8479

Mailing address

9987 Carver Rd Ste 250
Blue Ash, OH 45242-5553
Phone (937) 433-7536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170621000070 NC Part B Supplier - Clinic/Group Practice 3173891892 Receives reassigned benefits from 37 practitioners
Practice locations: Charlotte, NC; Cornelius, NC; Matthews, NC; Chapel Hill, NC
O20250509000707 SC Part B Supplier - Clinic/Group Practice 3173891892 Receives reassigned benefits from 9 practitioners
Practice locations: Myrtle Beach, SC

National Provider Directory

National Provider Directory

Locations

10502 Park Rd
Ste 100
Charlotte, NC 28210
Phone (704) 541-9092

11040 S Tryon St
Ste 203
Charlotte, NC 28273
Phone (704) 587-3200

330 Billingsley Rd
Ste 205
Charlotte, NC 28211
Phone (704) 323-8021

8814 Rachel Freeman Way
Ste 101
Charlotte, NC 28278

9987 Carver Rd
Ste 250
Blue Ash, OH 45242

Practitioners & affiliated clinicians

Practitioners 47

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.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774828800000",
    "number": "1619400033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9987 CARVER RD STE 250",
            "city": "BLUE ASH",
            "state": "OH",
            "postal_code": "452425553",
            "telephone_number": "937-433-7536",
            "fax_number": "937-433-9612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10502 PARK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108479",
            "telephone_number": "937-433-7536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROLINA DERMATOLOGY AND SKIN SURGERY SPECIALISTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-04",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A",
        "authorized_official_last_name": "KIRKLAND",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "BRENT",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "937-312-3820",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; 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.