DERMATOLOGIC SURGERY OF THE CAROLINAS LLC (NPI# 1790961670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790961670 |
| Entity Type | Organization |
| Organization Name | DERMATOLOGIC SURGERY OF THE CAROLINAS LLC |
| Practice Address |
15830 Ballantyne Medical Place Suite 225 Charlotte NC 28277 |
| Practice Telephone | 7049191105 |
| Practice Fax Number | 7049103163 |
| Mailing Telephone | 7049191105 |
| Mailing Fax Number | 7049103163 |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2014-06-02 |
| Authorized Official Name | DR. DAVID R LANE (OWNER) |
| Authorized Official Telephone | 7043023707 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
15830 BALLANTYNE MEDICAL PLACE SUITE 225 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28277 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083662548 | Ruth Anne Jameson | Nurse Practitioner | 15830 Ballantyne Medical Place, Suite 175, Charlotte, NC 28277 | 2006-05-05 |
| 1619124401 | Charlotte Gastroenterology & Hepatology, Pllc | Clinic/Center | 15830 Ballantyne Medical Place, Suite 175, Charlotte, NC 28277-3295 | 2008-08-22 |
| 1417093642 | Lesslie Marquez Durst | Physician Assistant | 15830 Ballantyne Medical Place, Suite 100, Charlotte, NC 28277 | 2007-01-29 |
| 1063429561 | John F Mahoney | Internal Medicine | 15830 Ballantyne Medical Place, Suite 200, Charlotte, NC 28277-3297 | 2006-08-01 |
| 1093744096 | David Richey Lane | Specialist | 15830 Ballantyne Medical Place, Ste 225, Charlotte, NC 28277-3294 | 2006-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255949731 | New Life Peer Support and Coaching LLC | Clinic/Center | 3450 Toringdon Way, Suite 200, Charlotte, NC 28277 | 2020-07-21 |
| 1083256762 | Speak Life Counseling Services, Pllc | Counselor | 16147 Lacaster Hwy, Suite 110, Charlotte, NC 28277 | 2019-10-14 |
| 1275010019 | Jigneshkumar R Mistry | Pharmacist | 11805 Allforth Ln Apt 2105, Charlotte, NC 28277 | 2018-07-24 |
| 1255825410 | Novant Medical Group Inc. | Family Medicine | 15033 Balloncroft Parkway, Suite 200, Charlotte, NC 28277 | 2018-06-20 |
| 1447752316 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 11135 Golf Links Dr, Charlotte, NC 28277 | 2018-03-06 |
| 1932607595 | Charlotte Proactive Md PC | Clinic/Center | 11220 Golf Links Drive North, Charlotte, NC 28277 | 2018-01-30 |
| 1003331521 | Accela Spine and Pain, Pllc | Anesthesiology | 10120 Ivey Chase Lane, Apt 617, Charlotte, NC 28277 | 2017-08-04 |
| 1265961619 | Dominicka Whitaker | Counselor | 12365 Bluestem Ln., Charlotte, NC 28277 | 2017-06-08 |
| 1083143408 | Monika D Hayes | Counselor | 11330 Snapfinger Drive, Charlotte, NC 28277 | 2017-06-08 |
| 1225582984 | Danielle Mcdaniel | Occupational Therapist | 5113 Piper Station Dr Ste 103, Charlotte, NC 28277 | 2016-08-11 |
| Find all providers in zip 28277 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528035722 | Marc Ronald Carruth | Dermatology | 2615 E 7th St, Charlotte, NC 28204-4376 | 2006-03-07 |
| 1619400033 | Metrolina Dermatology and Skin Surgery Specialists, Pllc | Dermatology | 10502 Park Rd, Charlotte, NC 28210-8479 | 2017-04-04 |
| 1861719494 | Sasha Jenkins Haberle | Dermatology | 10502 Park Rd, Ste 100, Charlotte, NC 28210-8479 | 2010-04-21 |
| 1174783385 | Jonathan M Olson | Dermatology | 15830 Ballantyne Medical Pl, Suite 225, Charlotte, NC 28277-4653 | 2008-06-11 |
| 1083700207 | Dermatology Laser and Vein Specialists of The Carolina's, Pllc | Dermatology | 1918 Randolph Rd, Suite 550, Charlotte, NC 28207-1100 | 2006-10-05 |
| 1992734669 | The Goslen Center for Skin Wellness, P.a. | Dermatology | 1918 Randolph Rd, Suite550, Charlotte, NC 28207-1100 | 2006-07-03 |
| 1265406482 | Junius Blake Goslen IIi | Dermatology | 1918 Randolph Rd, Suite 550, Charlotte, NC 28207-1100 | 2006-02-14 |
| 1215910336 | Girish Somashekhar Munavalli | Dermatology | 1918 Randolph Rd, Suite 550, Charlotte, NC 28207-1100 | 2005-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942713052 | Vieta Dermatology, Pllc | Dermatology | 289 Olmsted Blvd Ste 5, Pinehurst, NC 28374-8730 | 2017-11-10 |
| 1245751403 | Bluewater Dermatology and Skin Cancer Center Pa | Dermatology | 814 Spivey Rd, Whiteville, NC 28472-8736 | 2017-06-28 |
| 1831330893 | Landon Everett Stigall | Dermatology | 6752 Rock Spring Rd Ste 201, Wilmington, NC 28405 | 2009-03-20 |
| 1780772541 | Jenny L. Stone | Dermatology | 203 Mocksville Ave Ste B, Salisbury, NC 28144-3360 | 2006-10-10 |
| 1215902663 | Frederick Walter Gourdin | Dermatology | 78 Long Shoals Rd, Arden, NC 28704-7782 | 2006-02-21 |
| 1508846403 | Rajat Varma | Dermatology | 410 Market St Ste 400, Unc Dept of Dermatology, Chapel Hill, NC 27516-4061 | 2006-01-18 |
| 1437130523 | Greg Edwin Viehman | Dermatology | 710 Military Cutoff Rd, Suite 200, Wilmington, NC 28405-2375 | 2005-11-07 |
| 1598759482 | Eastern Dermatology, P.a. | Dermatology | 420 Spring Forest Rd, Greenville, NC 27834-7244 | 2005-09-07 |
| 1285636076 | Charles S Johnson | Dermatology | 315 19th St Se, Hickory, NC 28602-4230 | 2005-08-11 |
| 1134123847 | Audrey F Echt | Dermatology | 10931 Raven Ridge Rd, Ste 101, Raleigh, NC 27614-6499 | 2005-06-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.