Individual provider Active NPI

Lois Beard Martin, DO

  • Dermatology Physician
  • Wilmington, NC
National Provider Identifier
1679634018
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
9600064 Issued in NC
Practice address
5710 Oleander Dr Ste 103
Wilmington, NC 28403-4723
Phone
(910) 509-4116
Fax
(910) 509-7566
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 9600064 NC Primary

Addresses

Primary practice location

5710 Oleander Dr Ste 103
Wilmington, NC 28403-4723

Mailing address

1908 Eastwood Rd Ste 317
Wilmington, NC 28403-7235
Phone (910) 509-4116

Other practice location 1

1908 Eastwood Rd Ste 103
Wilmington, NC 28403-7229
Phone (910) 509-4116

Other identifiers 2

IdentifierTypeStateIssuer
0247ROtherNCBCBS
8954150MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100128000981 NC Practitioner - Dermatology 6204805567 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Ohio University, College of Osteopathic Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1908 Eastwood Rd
Suite 317
Wilmington, NC 28403-7235
Phone (910) 509-4116

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision72
Removal of skin lesions769

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Skin & Vein Center Inc. Dermatology CurrentSince Aug 26, 2002 Accepting new patients
Skin Surgery Center PA Dermatology Past Accepting new patients

Locations

1908 Eastwood Rd
Ste 317
Wilmington, NC 28403
Phone (910) 509-4116

4114 Shipyard Blvd
#B
Wilmington, NC 28403
Phone (910) 792-1338

7110 Wrightsville Ave
Ste B9
Wilmington, NC 28403
Phone (910) 509-4116

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1679634018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 EASTWOOD RD STE 317",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284037235",
            "telephone_number": "910-509-4116",
            "fax_number": "910-509-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5710 OLEANDER DR STE 103",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034723",
            "telephone_number": "910-509-4116",
            "fax_number": "910-509-7566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1908 Eastwood Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284037229",
            "country_code": "US",
            "telephone_number": "910-509-4116",
            "fax_number": "910-509-7566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LOIS",
        "middle_name": "BEARD",
        "name_prefix": "Ms.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "9600064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0247R",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8954150",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.