NPIMap

Organization Active NPI

Beckley Dermatology Inc.

Doing business as Dermatology Associates & Surgery Center

  • Dermatology Physician
  • Hagerstown, MD
National Provider Identifier
1891267936
Registry record updated Dec 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
BECKLEY DERMATOLOGY INC.
Doing business as
Dermatology Associates & Surgery Center
Practice address
1110 Professional CT Ste 201
Hagerstown, MD 21740-5945
Phone
(240) 707-6920
Fax
(240) 707-6926
NPI assigned
Dec 31, 2018
Last updated
Dec 31, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
BECKLEY DERMATOLOGY INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 31, 2018

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

Authorized official

Name
Nelson E. Velazquez, DONPI 1730189747
Title
Owner
Phone
(304) 252-2673

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X
Dermatopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0900X

Addresses

Primary practice location

1110 Professional CT Ste 201
Hagerstown, MD 21740-5945

Mailing address

136 Linden Dr Ste 104
Winchester, VA 22601-6900
Phone (540) 678-3588

Other names 1

  • Dermatology Associates & Surgery Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Beckley Dermatology Inc7 organizations share this tax ID, including this one
Part of
Beckley Dermatology Inc

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the 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": "1546214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546214400000",
    "number": "1891267936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 LINDEN DR STE 104",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226016900",
            "telephone_number": "540-678-3588",
            "fax_number": "540-678-9025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 PROFESSIONAL CT STE 201",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405945",
            "telephone_number": "240-707-6920",
            "fax_number": "240-707-6926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BECKLEY DERMATOLOGY INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BECKLEY DERMATOLOGY INC",
        "enumeration_date": "2018-12-31",
        "last_updated": "2018-12-31",
        "status": "A",
        "authorized_official_last_name": "VELAZQUEZ",
        "authorized_official_first_name": "NELSON",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-252-2673",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology Associates & Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2018; 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.