Organization Active NPI

Regional Dermatology of Durham

  • Dermatology Physician
  • Durham, NC
National Provider Identifier
1871893503
Registry record updated Sep 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
REGIONAL DERMATOLOGY OF DURHAM
Practice address
4321 Medical Park Dr
Suite 102
Durham, NC 27704-2199
Phone
(919) 220-7546
Fax
(919) 220-5805
NPI assigned
Oct 28, 2010
Last updated
Sep 26, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2011

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

Authorized official

Name
Dr. Elizabeth H Hamilton, MDNPI 1699745570
Title
Medical Doctor
Phone
(919) 220-7546

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
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

4321 Medical Park Dr
Suite 102
Durham, NC 27704-2199

Mailing address

4321 Medical Park Dr
Suite 102
Durham, NC 27704-2199
Phone (919) 220-7546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110207000553 NC Part B Supplier - Clinic/Group Practice 6800076993 Receives reassigned benefits from 4 practitioners
Practice locations: Durham, NC

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2017655Regional Dermatology of Durham, PLLC4321 Medical Park Drive, Suite 102, Durham, NC 27704Provider-performed microscopyDec 14, 2026

National Provider Directory

National Provider Directory

Locations

4321 Medical Park Dr
Ste 102
Durham, NC 27704
Phone (919) 220-7546

Practitioners & affiliated clinicians

Practitioners 5

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": "1288224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316995200000",
    "number": "1871893503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 MEDICAL PARK DR",
            "address_2": "SUITE 102",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042199",
            "telephone_number": "919-220-7546",
            "fax_number": "919-220-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 MEDICAL PARK DR",
            "address_2": "SUITE 102",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042199",
            "telephone_number": "919-220-7546",
            "fax_number": "919-220-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGIONAL DERMATOLOGY OF DURHAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-28",
        "last_updated": "2011-09-26",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "919-220-7546",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; 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.