Dermatology Associates of the Lowcountry

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY ASSOCIATES OF THE LOWCOUNTRY

Practice address

108 Medical Park Dr
Walterboro, SC 29488-5719

Phone

(843) 549-6945

Fax

(843) 549-6741

NPI assigned

Jul 3, 2006

Last updated

Mar 14, 2008By 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

Dolores J Wade

Title

Asst. MGR

Phone

(843) 689-5259

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Heritage Dermatology PC

  • Dermatology Physician
  • Hilton Head Island, SC
  • NPI 1306875950

  O20040202001116

  Same enrollment
• Heritage Dermatology PC

  • Dermatology Physician
  • Bluffton, SC
  • NPI 1427087089

  O20040202001116

  Same enrollment
• Heritage Dermatology PC

  • Dermatology Physician
  • Beaufort, SC
  • NPI 1982630125

  O20040202001116

  Same enrollment

Locations

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1801825468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 MAIN ST",
            "address_2": "SUITE D",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299264614",
            "telephone_number": "843-689-5259",
            "fax_number": "843-689-3797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 MEDICAL PARK DR",
            "city": "WALTERBORO",
            "state": "SC",
            "postal_code": "294885719",
            "telephone_number": "843-549-6945",
            "fax_number": "843-549-6741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES OF THE LOWCOUNTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "DOLORES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ASST. MGR",
        "authorized_official_telephone_number": "843-689-5259"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cory Noel Davis, LDO
• Jennifer E Davis, M.S.
• Kevin Thomas Deane, RPH
• Amy Sauls Delong, RN
• Lucinda Demarco, M.D.
• Sara Dibiase
• Bergdorf Dixon
• Jennifer J Dombek, HIS
• Averi Drawdy
• Yvone Drayton, B.S.

• Dermatology Physician in Walterboro, SC
• Providers in Walterboro, SC by specialty
• Dermatology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.