Burlington Dermatology Center, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

13641 Issued in NC

Legal business name

BURLINGTON DERMATOLOGY CENTER, INC.

Practice address

1522 Vaughn Rd
Burlington, NC 27217-2871

Phone

(336) 226-9393

Fax

(336) 227-0496

NPI assigned

Feb 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Richard Robert Henderson, M.D.

Title

Doctor

Phone

(336) 226-9393

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272585600000",
    "number": "1962544767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1522 VAUGHN RD",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272172871",
            "telephone_number": "336-226-9393",
            "fax_number": "336-227-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1522 VAUGHN RD",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272172871",
            "telephone_number": "336-226-9393",
            "fax_number": "336-227-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURLINGTON DERMATOLOGY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2010-04-30",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "336-226-9393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NC",
            "license": "13641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901143",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8941461",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.