Davie Dermatology, P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

DAVIE DERMATOLOGY, P.A.

Practice address

108 Dornach Way
Advance, NC 27006-7305

Phone

(336) 940-2407

Fax

(336) 940-2409

NPI assigned

Apr 6, 2006

Organization subpart

No

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

Authorized official

Name

Tracie C Bryson, MDNPI 1982698288

Title

Authorized Official

Phone

(336) 940-2407

Specialties & licenses 1

Addresses

Other identifiers 1

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

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracie C Bryson, M.D.

  • Dermatology Physician
  • Advance, NC
  • NPI 1982698288

  Specialist

  Medicare reassignment Care Compare group NPD Authorized official
• Kelly Lynne Barham, M.D.

  • Specialist
  • Advance, NC
  • NPI 1447454160
  Medicare reassignment Care Compare group NPD
• Amy Elizabeth Devore, MD

  • Dermatology Physician
  • Mount Airy, NC
  • NPI 1063559441
  Medicare reassignment Care Compare group NPD
• Aubrey Allen Hess, MD

  • Dermatology Physician
  • Advance, NC
  • NPI 1124685979
  Medicare reassignment Care Compare group NPD
• Jaclyn Hess, MD

  • Dermatology Physician
  • Advance, NC
  • NPI 1154717544
  Medicare reassignment Care Compare group NPD
• Olivia Bosshardt Hughes, M.D.

  • Dermatology Physician
  • Advance, NC
  • NPI 1174055164
  Medicare reassignment Care Compare group NPD
• Frank Lacy, MD

  • MOHS-Micrographic Surgery Physician
  • Advance, NC
  • NPI 1457855835
  Medicare reassignment Care Compare group NPD
• Alexandra Elizabeth Zeitany, MD

  • Dermatology Physician
  • Advance, NC
  • NPI 1689036428
  Medicare reassignment Care Compare group NPD
• Stefanie Marie Alvis, PA-C

  • Medical Physician Assistant
  • Advance, NC
  • NPI 1114207065
  Medicare reassignment Care Compare group
• Kelly R Crawford, PA-C

  • Medical Physician Assistant
  • Advance, NC
  • NPI 1801892492
  Medicare reassignment Care Compare group
• Carol Derosa Grabow, PA-C

  • Medical Physician Assistant
  • Advance, NC
  • NPI 1689696643
  Medicare reassignment Care Compare group
• Aurleigh Stimmel, PA-C

  • Physician Assistant
  • Advance, NC
  • NPI 1265072235
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1922060649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 DORNACH WAY",
            "city": "ADVANCE",
            "state": "NC",
            "postal_code": "270067305",
            "telephone_number": "336-940-2407",
            "fax_number": "336-940-2409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 DORNACH WAY",
            "city": "ADVANCE",
            "state": "NC",
            "postal_code": "270067305",
            "telephone_number": "336-940-2407",
            "fax_number": "336-940-2409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIE DERMATOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "BRYSON",
        "authorized_official_first_name": "TRACIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "336-940-2407",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890108V",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Cornwall, PA C
• Morgan Costner, PHARM. D
• Kelly R Crawford, PA-C
• Valerie Crawford, RBT
• Davie Allergy and Asthma Clinic, PA
• Margaret Riddle Davis, MA., LPC
• Digestive Health Specialists, PA
• Digestive Health Specialists, PA
• Adam T. Dorsett, D.D.S
• Dr. Todd Carter D.D.S

• Specialist in Advance, NC
• Providers in Advance, NC by specialty
• Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; 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.