Individual provider Active NPI

Kevin Nethers, M.D.

  • Dermatology Physician
  • Cary, NC
National Provider Identifier
1932631009
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
62256 Issued in AZ
Practice address
150 Wellesley Trade LN Ste 204
Cary, NC 27519-5593
Phone
(919) 230-4016
Fax
(919) 230-4017
NPI assigned
Mar 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 62256 AZ Primary

Addresses

Primary practice location

150 Wellesley Trade LN Ste 204
Cary, NC 27519-5593

Mailing address

150 Wellesley Trade LN Ste 204
Cary, NC 27519-5593
Phone (919) 230-4016

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210215001756 AZ Practitioner - Dermatology 9830504323 Reassigns benefits to 1 organization
I20250421000327 NC Practitioner - Dermatology 9830504323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of South Florida College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cary Skin Center PAGroup PAC ID 1153418371, 10 clinicians

Practice addresses (Care Compare)

150 Wellesley Trade LN
Suite 204
Cary, NC 27519-5593
Phone (919) 230-4016

Merit-based Incentive Payment System (MIPS)

Final score
95.11 of 100Reported as group
Quality
100
Improvement activities
40
Cost
83.7

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision12
Removal of skin lesions253
Removal or shaving of skin growth1-10
Skin biopsy104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
62256AZMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cary Skin Center, PA CurrentSince May 1, 2025 Accepting new patients
Regency Skin Institute PLLC CurrentSince Jan 25, 2021 Accepting new patients
Pih Health Physicians Family Medicine Past Accepting new patients
Regency Reconstruction PLLC Past Accepting new patients

Locations

10240 W Indian School Rd
Ste 115
Phoenix, AZ 85037
Phone (623) 243-9077

14725 W Mountain View Blvd
Surprise, AZ 85374
Phone (623) 243-9077

14869 W Bell Rd
Ste 103
Surprise, AZ 85374

200 Wellesley Trade Ln
Cary, NC 27519
Phone (919) 363-7546

150 Wellesley Trade Ln
Ste 204
Cary, NC 27519
Phone (919) 230-4016

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1932631009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 WELLESLEY TRADE LN STE 204",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275195593",
            "telephone_number": "919-230-4016",
            "fax_number": "919-230-4017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 WELLESLEY TRADE LN STE 204",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275195593",
            "telephone_number": "919-230-4016",
            "fax_number": "919-230-4017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETHERS",
        "first_name": "KEVIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-29",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AZ",
            "license": "62256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.