Cary Skin Center, PA

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

81706 Issued in NC

Legal business name

CARY SKIN CENTER, PA

Practice address

200 Wellesley Trade LN
Cary, NC 27519-5576

Phone

(919) 363-7546

Fax

(919) 363-3616

NPI assigned

Apr 6, 2006

Last updated

Apr 28, 2020By 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

Robert E Clark, MD, PHDNPI 1982600789

Title

President

Phone

(919) 363-7546

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

CLIA laboratory certificates

Locations

Interoperability endpoints

• Direct secure messaging: rclark@directaddress.net

Practitioners 11

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.

• Robert Earl Clark, M.D., PHD

  • MOHS-Micrographic Surgery Physician
  • Cary, NC
  • NPI 1982600789
  Medicare reassignment Care Compare group NPD Authorized official
• Joshua Brian Eickstaedt, M.D.

  • MOHS-Micrographic Surgery Physician
  • Charlotte, NC
  • NPI 1093961971
  Medicare reassignment Care Compare group NPD
• Colin Hayes Gage, PA-C

  • Physician Assistant
  • Cary, NC
  • NPI 1184987877
  Medicare reassignment Care Compare group NPD
• Adam Ingraffea, M.D.

  • MOHS-Micrographic Surgery Physician
  • Cary, NC
  • NPI 1427370352
  Medicare reassignment Care Compare group NPD
• Wendy Leigh Jaget, NP

  • Nurse Practitioner
  • Cary, NC
  • NPI 1104278803
  Medicare reassignment Care Compare group NPD
• Kevin Nethers, M.D.

  • Dermatology Physician
  • Cary, NC
  • NPI 1932631009
  Medicare reassignment Care Compare group NPD
• Shannon Michelle Craven, PA-C

  • Physician Assistant
  • Pinehurst, NC
  • NPI 1245518281
  Medicare reassignment Care Compare group
• Timothy Corcoran Flynn, M.D.

  • MOHS-Micrographic Surgery Physician
  • Cary, NC
  • NPI 1154302610
  Medicare reassignment Care Compare group
• Mary Candace Seagle, PA-C

  • Physician Assistant
  • Cary, NC
  • NPI 1679869366
  Medicare reassignment Care Compare group
• Heather L Amitrone, PA-C

  • Physician Assistant
  • Irvine, CA
  • NPI 1225066426

  NC

  Medicare reassignment Care Compare group
• Paul Stephen Toth, P.A.

  • Physician Assistant
  • Cary, NC
  • NPI 1619035946
  NPD (past)

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588032000000",
    "number": "1902869530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WELLESLEY TRADE LN",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275195576",
            "telephone_number": "919-363-7546",
            "fax_number": "919-363-3616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WELLESLEY TRADE LN",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275195576",
            "telephone_number": "919-363-7546",
            "fax_number": "919-363-3616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Regional Cir Ste B&c",
            "address_purpose": "LOCATION",
            "city": "Pinehurst",
            "state": "NC",
            "postal_code": "283749863",
            "country_code": "US",
            "telephone_number": "910-295-1761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CARY SKIN CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-363-7546",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NC",
            "license": "81706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01603",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901603",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLPATH",
            "identifier": "30557",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rclark@directaddress.net",
            "affiliation": "N",
            "address_1": "200 Wellesley Trade Ln",
            "city": "Cary",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275195576",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rclark@directaddress.net",
            "affiliation": "N",
            "address_1": "5 Regional Cir Ste B&c",
            "city": "Pinehurst",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283749863",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cary Primary Care
• Cary Primary Care PA
• Cary Psychiatry
• Cary Rheumatology & Arthritis Associates PA
• Cary Senior Housing I Opco, LLC (Swift Creek Health Center)
• Cary Speech Services, Inc.
• Cary Surgical Specialists PC
• Cary THMD, PLLC
• Cary Vision Care, O.D., P.a. (Cary Vision Care)
• Cary Vision Therapy and Neuro-Optometric Rehabilitation, PLLC

• MOHS-Micrographic Surgery Physician in Cary, NC
• Providers in Cary, NC by specialty
• MOHS-Micrographic Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2020; 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.