Falling Leaves Dermatology Mooresville LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

FALLING LEAVES DERMATOLOGY MOORESVILLE LLC

Practice address

136 Corporate Park Dr Ste H
Mooresville, NC 28117-6960

Phone

(561) 670-0756

NPI assigned

Apr 18, 2019

Last updated

Jun 11, 2019By 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

James E Saylor

Title

Manager

Phone

(561) 670-0756

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1902469570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 CORPORATE PARK DR STE H",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281176960",
            "telephone_number": "561-670-0756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 CORPORATE PARK DR STE H",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281176960",
            "telephone_number": "561-670-0756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALLING LEAVES DERMATOLOGY MOORESVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-18",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "SAYLOR",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-670-0756"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.