Kerry Mark Shafran, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

39997 Issued in NC

Practice address

17039 Kenton Dr Ste 100
Cornelius, NC 28031-5776

Phone

(704) 896-8837

Fax

(704) 896-8892

NPI assigned

Aug 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Dermatology

Education

Wake Forest University School of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Skin Surgery Center PAGroup PAC ID 3173599479, 72 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.65 of 100Reported as group

Promoting interoperability

89

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Skin Surgery Center PA

  • Dermatology Physician
  • Winston Salem, NC
  • NPI 1649237082
  Medicare reassignment Care Compare group NPD
• University Dermatology, PLLC

  • Specialist
  • Charlotte, NC
  • NPI 1588711584
  NPD (past) Authorized official
• Skin Surgery Center PA

  dba The Skin Surgery Center of Charleston

  • MOHS-Micrographic Surgery Physician
  • Mount Pleasant, SC
  • NPI 1851810279
  NPD

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1740394543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17039 KENTON DR STE 100",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280315776",
            "telephone_number": "704-896-8837",
            "fax_number": "704-896-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17039 KENTON DR STE 100",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280315776",
            "telephone_number": "704-896-8837",
            "fax_number": "704-896-8892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFRAN",
        "first_name": "KERRY",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "39997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0179T",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica W Schultz, ATC,LAT
• Lucia Elizabeth Scire, COTA/L
• Keyont'E Scott, DHSC, LCSWA
• Emily Madison See, LCMHC, NCC, MA
• Serenitybay Counseling PLLC
• Minette Shankoff
• Angela Sharkey, CLT, LMBT, BCTMB
• Alyssa Sharp, MS, RD, CDCES
• Jacqueline Shelter
• Kenadie Sherman

• Dermatology Physician in Cornelius, NC
• Providers in Cornelius, 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 Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.