DERMATOPATHOLOGY SPECIALISTS JIM PHILLIPS MD DERMATOPATHOLOGIST LLC NPI 1003009390
Dermatology (Dermatopathology) in Mt Pleasant, SC
About DERMATOPATHOLOGY SPECIALISTS JIM PHILLIPS MD DERMATOPATHOLOGIST LLC
Dermatopathology Specialists Jim Phillips Md Dermatopathologist Llc is a provider established in Mt Pleasant, South Carolina specializing in dermatology (dermatopathology) . The NPI number of Dermatopathology Specialists Jim Phillips Md Dermatopathologist Llc is 1003009390 and was assigned on August 2007. The practitioner's primary taxonomy code is 207ND0900X with license number 8871 (SC). The provider is registered as an organization and their NPI record was last updated 13 years ago. Dermatopathology Specialists Jim Phillips Md Dermatopathologist Llc operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. James H. Phillips Md (Owner)
The CLIA number of Dermatopathology Specialists Jim Phillips Md Dermatopathologist Llc is 42D1087626 registered as a "independent" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued to Dermatopathology Specialists Jim Phillips Md Dermatopathologist Llc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
| NPI | 1003009390 |
| Provider Name | DERMATOPATHOLOGY SPECIALISTS JIM PHILLIPS MD DERMATOPATHOLOGIST LLC |
| Provider Location Address | 1280 JOHNNIE DODDS BLVD SUITE 101 MT PLEASANT, SC 29464 |
| Provider Mailing Address | PO BOX 30309 CHARLESTON, SC 29417 |
| NPI Entity Type | Organization |
| Is Sole Proprietor? | N/A |
| Is Organization Subpart? | No |
| Enumeration Date | 08-21-2007 |
| Last Update Date | 03-23-2009 |
Primary Taxonomy
| Taxonomy Code | 207ND0900X |
| Classification | Dermatology |
| Type | Allopathic & Osteopathic Physicians |
| Specialization | Dermatopathology |
| License No. | 8871 |
| License State | SC |
| Taxonomy Description | A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. |
Business Address
DERMATOPATHOLOGY SPECIALISTS JIM PHILLIPS MD DERMATOPATHOLOGIST LLC
1280 JOHNNIE DODDS BLVD
SUITE 101
MT PLEASANT, SC
ZIP 29464
Phone: (843) 375-0055
Mailing Address
DERMATOPATHOLOGY SPECIALISTS JIM PHILLIPS MD DERMATOPATHOLOGIST LLC
PO BOX 30309
CHARLESTON, SC
ZIP 29417
Phone: (843) 554-9300
Fax: (843) 566-8780
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003009390 is:
| CLIA Number | 42D1087626 |
| Facility Type | INDEPENDENT |
| Certificate Type | Certificate of Compliance |
Group Taxonomy
193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Additional Identifiers
Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State |
|---|---|---|
| GP4721 | MEDICAID (05) | SC |
| 8849 | MEDICARE PIN (08) | SC |
| DG5570 | MEDICARE PIN (08) | SC |
Other Providers at the same location
The following 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1659345643 | JENNIFER NELSON MAZUR PHARMD Individual | Pharmacist | 1280 JOHNNIE DODDS BLVD SUITE 105 MOUNT PLEASANT, SC 29464 (843) 971-1046 |
| 1972570372 | DR. JAMES HARRISON PHILLIPS MD Individual | Pathology (Dermatopathology) | 1280 JOHNNIE DODDS BLVD SUITE 104 MT PLEASANT, SC 29464 (843) 284-4799 |
NPI Footnotes
What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.
Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date
The date that a NPI record was last updated or changed.
Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.