Beckley Dermatology Inc.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

BECKLEY DERMATOLOGY INC.

Doing business as

Dermatology Associates & Surgery Center

Practice address

94 Brookshire Lane
Beckley, WV 25801-6765

Phone

(304) 252-2673

Fax

(304) 929-2350

NPI assigned

Aug 9, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Nelson E. Velazquez, DO

Title

Sole Owner

Phone

(304) 252-2673

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• Dermatology Associates & Surgery Center Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487116800000",
    "number": "1720089279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 LINDEN DR",
            "address_2": "SUITE 101",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226016909",
            "telephone_number": "540-504-0066",
            "fax_number": "540-678-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 BROOKSHIRE LANE",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258016765",
            "telephone_number": "304-252-2673",
            "fax_number": "304-929-2350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BECKLEY DERMATOLOGY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2017-02-15",
        "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": "Mr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "WV",
            "license": null,
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "WV",
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "WV",
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "WV",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258407700",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720089279",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology Associates & Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Beckley Cardiology, PLLC
• Beckley Emergency Physicians LLC
• Beckley Gastroenterology Inc
• Beckley Health Right, Inc
• Beckley Hearing Center, Inc.
• Beckley Medical Imaging Inc.

• Dermatology Physician in Beckley, WV
• Providers in Beckley, WV by specialty
• Dermatology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.