Carolina Mountain Dermatology, PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

40729 Issued in NC

Legal business name

CAROLINA MOUNTAIN DERMATOLOGY, PA

Practice address

78 Long Shoals Rd
Arden, NC 28704-7782

Phone

(828) 684-0703

Fax

(828) 684-5344

NPI assigned

Apr 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Michael David Cogburn, MD

Title

President

Phone

(828) 684-0703

Specialties & licenses 1

Addresses

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 1

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

• Frederick Walter Gourdin, MD

  • MOHS-Micrographic Surgery Physician
  • Arden, NC
  • NPI 1215902663
  NPD

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982669131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 LONG SHOALS RD",
            "city": "ARDEN",
            "state": "NC",
            "postal_code": "287047782",
            "telephone_number": "828-684-0703",
            "fax_number": "828-684-5344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 LONG SHOALS RD",
            "city": "ARDEN",
            "state": "NC",
            "postal_code": "287047782",
            "telephone_number": "828-684-0703",
            "fax_number": "828-684-5344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA MOUNTAIN DERMATOLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COGBURN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "828-684-0703",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "NC",
            "license": "40729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Capell, PHARM.D.
• Dane Jorgen Capener, DMD
• Caresouth Private Duty of North Carolina, LLC
• Robert Carling, RN
• Laura Nicole Carlson, PA-C
• Carolina Optometric of Arden PA
• Kristin Mae Mishrell Carson, DPT
• Carole P Carter, FNP
• Casey Cho DDS PLLC
• Sarah Harris Cash, MD

• Dermatology Physician in Arden, NC
• Providers in Arden, 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.