Active NPI
Eastern Dermatology & Pathology
- Dermatology Physician
- Elizabeth City, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Legal business name
- EASTERN DERMATOLOGY & PATHOLOGY
- Practice address
- 800 N McPherson Xing
Elizabeth City, NC 27909-9673 - Phone
- (252) 331-1780
- Fax
- (252) 331-2876
- NPI assigned
- Nov 21, 2006
- Last updated
- Jun 28, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Cameron L Smith, MD
- Title
- President
- Phone
- (252) 752-4124
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | Primary |
Addresses
Primary practice location
800 N McPherson Xing
Elizabeth City, NC 27909-9673
Mailing address
420 Spring Forest Rd
Greenville, NC 27834-7244
Phone (252) 752-4124
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040624001141 | NC | Part B Supplier - Clinic/Group Practice | 2860478542 |
Receives reassigned benefits from 21 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Newport, NC; Washington, NC; New Bern, NC; Greenville, NC; Elizabeth City, NC; Edenton, NC |
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 34D1037270 | Eastern Dermatology and Pathology, PA | Provider-performed microscopy | Feb 20, 2027 |
National Provider Directory
National Provider DirectoryOwnership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Dermatology Physician
- Washington, NC
- NPI 1760713671
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Dermatology Physician
- Greenville, NC
- NPI 1770504060
-
- Dermatology Physician
- Greenville, NC
- NPI 1720288442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1340841600000",
"number": "1932274610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 SPRING FOREST RD",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278347244",
"telephone_number": "252-752-4124",
"fax_number": "252-758-8954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 N MCPHERSON XING",
"city": "ELIZABETH CITY",
"state": "NC",
"postal_code": "279099673",
"telephone_number": "252-331-1780",
"fax_number": "252-331-2876"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EASTERN DERMATOLOGY & PATHOLOGY",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-21",
"last_updated": "2012-06-28",
"status": "A",
"authorized_official_last_name": "SMITH",
"authorized_official_first_name": "CAMERON",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "252-752-4124",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Elizabeth City, NC
- Eagle Acquisition VI LLC (Concordia Transitional Care and Rehabilitation - Elizabeth City)
- Ear,Nose&Throat Head,Neck&Sinus Surgery,PC
- East Carolina University (East Carolina University School of Dental Medicine,CSLC Elizabeth City)
- Easter Seals Ucp North Carolina & Virginia, Inc.
- Eastern Carolina Cardiovascular, PA
- Ecsu Student Health Services
- Edward B Eadie Jr MD Womens Urology
- Alexis Vikketta Edwards, FNP-BC
- Christopher Noel Edwards, LCSW
- Elizabeth City Health and Rehabilitation, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; 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.