360 Dermatology, PC
Organization Active NPI Dermatology Physician · Franklin, TN
NPI 1891432159 · NPPES record last updated Oct 29, 2024
Key facts
- NPI
- 1891432159
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- Legal business name
- 360 DERMATOLOGY, PC
- Practice address
- 2001 Mallory LN Ste 207
Franklin, TN 37067-8235 - Phone
- (615) 488-3376
- Fax
- (817) 612-3586
- NPI assigned
- May 18, 2022
- Organization subpart
- No
Authorized official
- Name
- Nashay Clemetson, MD
- Title
- Co-Owner
- Phone
- (615) 488-3376
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 44D2272025 | 360 Dermatology, PC | Provider-performed microscopy | Nov 13, 2026 |
National Provider Directory
Interoperability endpoints
- https://app.meldrx.com/api/fhir/ez_00002
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | Yes |
Addresses
Primary practice location
2001 Mallory LN Ste 207
Franklin, TN 37067-8235
Mailing address
2001 Mallory LN Ste 207
Franklin, TN 37067-8235
Phone (615) 488-3376
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | support@my360derm.com |
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.