Eastern Dermatology & Pathology

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

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

Organization subpart

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Eastern Dermatology PA

  • Dermatology Physician
  • Edenton, NC
  • NPI 1972715241

  O20040624001141

  Same enrollment
• Eastern Dermatology, P.a.

  • Dermatology Physician
  • Greenville, NC
  • NPI 1598759482

  O20040624001141

  Same enrollment
• Eastern Dermatology, PA

  • Dermatology Physician
  • New Bern, NC
  • NPI 1306058672

  O20040624001141

  Same enrollment

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

CLIA laboratory certificates

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.

• Eastern Dermatology & Pathology, PA

  • Dermatology Physician
  • Washington, NC
  • NPI 1760713671
  NPPES parent name

Practitioners 1

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

• Virginia B Taylor, M.D.

  • Dermatology Physician
  • Greenville, NC
  • NPI 1720288442
  NPD

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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "01498",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5902503",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Elizabeth City, NC
• Providers in Elizabeth City, NC by specialty
• Dermatology Physician in North Carolina

• 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.

Verify at the official NPI Registry.