Dermatologic Surgery of the Carolinas LLC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

DERMATOLOGIC SURGERY OF THE CAROLINAS LLC

Practice address

15830 Ballantyne Medical Place
Suite 225
Charlotte, NC 28277

Phone

(704) 919-1105

Fax

(704) 910-3163

NPI assigned

Jan 10, 2008

Last updated

Jun 2, 2014By 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. David R Lane, MDNPI 1093744096

Title

Owner

Phone

(704) 302-3707

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC, NC2 enrollments

Enrollment records 2

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

Interoperability endpoints

• Direct secure messaging: elizabeth-grattan@dermcarecharlotte.e-mdsdirect.com
• FHIR API: https://fhir4.healow.com/fhir/r4/JGGEAA
• Direct secure messaging: james-seward@dermcarecharlotte.e-mdsdirect.com
• Direct secure messaging: jocelyn-larocque@dermcarecharlotte.e-mdsdirect.com
• Direct secure messaging: lesslie-durst@dermcarecharlotte.e-mdsdirect.com
• Direct secure messaging: lisa-matuga@dermcarecharlotte.e-mdsdirect.com

Practitioners 10

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.

• David Richey Lane, M.D.

  • MOHS-Micrographic Surgery Physician
  • Charlotte, NC
  • NPI 1093744096

  SC

  Medicare reassignment Care Compare group Authorized official
• Matthew Ryan Clark, M.D.

  • MOHS-Micrographic Surgery Physician
  • Bend, OR
  • NPI 1194162230

  NC, SC

  Medicare reassignment Care Compare group NPD
• Jessica Alexis Savas, M.D

  • Dermatology Physician
  • Winston Salem, NC
  • NPI 1083031090

  SC

  Medicare reassignment Care Compare group
• Lauren Jenkins, M.D.

  • MOHS-Micrographic Surgery Physician
  • Charlotte, NC
  • NPI 1821477811

  SC

  Medicare reassignment NPD
• Jonathan M Olson, MD

  • MOHS-Micrographic Surgery Physician
  • Charlotte, NC
  • NPI 1174783385

  SC

  Medicare reassignment NPD
• Lesslie Marquez Durst, P.A.-C

  • Physician Assistant
  • Charlotte, NC
  • NPI 1417093642
  NPD
• Elizabeth Gambrell Grattan, M.D.

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1477641801
  NPD
• Jocelyn H Larocque, D.O.

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1831178631
  NPD
• Lisa Michelle Matuga, LISA MATUGA, PA-C

  • Medical Physician Assistant
  • Charlotte, NC
  • NPI 1982854774
  NPD
• James L Seward, MD

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1326081142
  NPD

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401667200000",
    "number": "1790961670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15830 BALLANTYNE MEDICAL PLACE",
            "address_2": "SUITE 225",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28277",
            "telephone_number": "704-919-1105",
            "fax_number": "704-910-3163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15830 BALLANTYNE MEDICAL PLACE",
            "address_2": "SUITE 225",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28277",
            "telephone_number": "704-919-1105",
            "fax_number": "704-910-3163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGIC SURGERY OF THE CAROLINAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2014-06-02",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-302-3707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim H Derhodes, RPH
• Sheri Derienzo, RN
• Derive Health, PA
• Artem Derkachev
• Chelsea R Dermady
• Dermatology Care of Charlotte, PA
• Dermatology Laser and Vein Specialists of the Carolina's, PLLC
• Dermatology Practice of the Carolinas PA
• Dermatology Specialists of Charlotte PA
• Sarah Shaw Dermes, PA-C

• MOHS-Micrographic Surgery Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• MOHS-Micrographic Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.