NPIMap

Organization Active NPI

Dermone

  • Medical Physician Assistant
  • Clinton, NC
National Provider Identifier
1811371685
Registry record updated Jul 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Legal business name
DERMONE
Practice address
603 Beaman St
Clinton, NC 28328-2650
Phone
(910) 590-1049
NPI assigned
Jul 12, 2015
Last updated
Jul 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2015

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

Authorized official

Name
Dr. David L Tolliver, D.O.NPI 1831176296
Title
Physician
Phone
(276) 326-3376

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X NU Primary

Addresses

Primary practice location

603 Beaman St
Clinton, NC 28328-2650

Mailing address

725 S College Ave
Bluefield, VA 24605-1640
Phone (276) 326-3376

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1436659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436659200000",
    "number": "1811371685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 S COLLEGE AVE",
            "city": "BLUEFIELD",
            "state": "VA",
            "postal_code": "246051640",
            "telephone_number": "276-326-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 BEAMAN ST",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "283282650",
            "telephone_number": "910-590-1049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMONE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-12",
        "last_updated": "2015-07-12",
        "status": "A",
        "authorized_official_last_name": "TOLLIVER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "276-326-3376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.