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DERMATOLOGY ASSOCIATES OF COASTAL CAROLINA
NPI 1033459011
Dermatology - Clinical & Laboratory Dermatological Immunology in Jacksonville, NC

Active since February 27, 2013CLIA 34D2056673 · Certificate of Compliance
2145 COUNTRY CLUB RD, JACKSONVILLE, NC 28546(252) 633-4461(252) 633-6016 Get Directions Write a Review

NPPES record last updated: September 21, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dermatology Associates Of Coastal Carolina NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DERMATOLOGY ASSOCIATES OF COASTAL CAROLINA (NPI 1033459011) is a healthcare organization registered as a clinical & laboratory dermatological immunology in Jacksonville, North Carolina and active in the NPI registry since February 2013. The organization holds a CLIA Certificate of Compliance certificate valid through March 26, 2028 and lists James Polo, Md/owner, as its authorized official.

NPPES Registry Identity

NPI1033459011
Entity TypeOrganization
Primary Taxonomy207NI0002X
Legal Business NameDERMATOLOGY ASSOCIATES OF COASTAL CAROLINA
Location Address2145 COUNTRY CLUB RDJacksonville, NC 28546-2403
Mailing AddressPo Box 890283Charlotte, NC 28289-0283 · (252) 633-4461 · Fax (252) 633-6016
Phone(252) 633-4461
Fax(252) 633-6016
Organization SubpartNo
Authorized OfficialJames PoloMd/owner · (252) 633-4461
Enumeration DateFebruary 27, 2013
Last NPPES UpdateSeptember 21, 2022
NPPES CertifiedSeptember 21, 2022
✔ NPI 1033459011 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · Clinical & Laboratory Dermatological ImmunologyAllopathic & Osteopathic Physicians
Taxonomy Code207NI0002X
Definition
A dermatologist who utilizes various specialized laboratory procedures to diagnose disorders characterized by defective responses of the body's immune system. Immunodermatologists also may provide consultation in the management of these disorders and administer specialized forms of therapy for these diseases.
2145 COUNTRY CLUB RD, Jacksonville, NC 28546
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dermatology Associates Of Coastal Carolina is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

7

Medicare enrollment records show 7 clinicians reassign Medicare billing to Dermatology Associates Of Coastal Carolina, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (7)

Sean Murphy, D.O.
Dermatology
NPI 1104898717
2115 NEUSE BLVD
New Bern, NC 28560
(252) 633-4461
✔ PECOS✔ Accepts Medicare29 mi
James Polo, M.D.
Dermatology
NPI 1093731168
2115 NEUSE BLVD
New Bern, NC 28560
(252) 633-4461
✔ PECOS✔ Accepts Medicare29 mi
Lauren Cowell, ACNP
Nurse Practitioner
NPI 1477146090
2115 NEUSE BLVD
New Bern, NC 28560
(252) 633-4461
✔ PECOS✔ Accepts Medicare36 mi
Scott Mcclellan, M.D.
Dermatology
NPI 1609961853
2115 NEUSE BLVD
New Bern, NC 28560
(252) 633-4461
✔ PECOS✔ Accepts Medicare36 mi
Julie Thompson, FNP
Nurse Practitioner
NPI 1013970417
702 N MAIN ST
Roxboro, NC 27573
(336) 599-9271
✔ PECOS144 mi
James Contestable, M.D.
Dermatology
NPI 1902244817
620 JOHN PAUL JONES CIR
Portsmouth, VA 23708
(757) 953-0292
✔ PECOS✔ Accepts Medicare154 mi
Thomas Evans, DO
Dermatology
NPI 1568757086
2959 SISKIYOU BLVD STE B
Medford, OR 97504
(541) 773-3636
✔ PECOS✔ Accepts Medicare2,486 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 34D2056673

Dermatology Associates Of Coastal Carolina · Jacksonville, NC
Active · expires Mar 26, 2028
CLIA Number34D2056673
Laboratory TypePractitioner Other
Certificate Effective DateMarch 27, 2026
Certificate Expiration DateMarch 26, 2028
Laboratory DirectorScott D. Mcclellan
Laboratory Phone(910) 333-9337
Laboratory LocationDermatology Associates Of Coastal Carolina2145 Country Club Rd, Suite 100, Jacksonville, NC 28546
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dermatology Associates Of Coastal Carolina's NPI number?

The NPI number for Dermatology Associates Of Coastal Carolina is 1033459011. It was assigned to this organization in the NPPES registry on February 27, 2013.

Where is Dermatology Associates Of Coastal Carolina located?

Dermatology Associates Of Coastal Carolina is located at 2145 Country Club Rd, Jacksonville, NC 28546. The listed phone number is (252) 633-4461.

What is Dermatology Associates Of Coastal Carolina's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Clinical & Laboratory Dermatological Immunology, with taxonomy code 207NI0002X.

Is Dermatology Associates Of Coastal Carolina enrolled in Medicare?

Yes. Dermatology Associates Of Coastal Carolina is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dermatology Associates Of Coastal Carolina?

According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 2 Medicare specialties reassign their Medicare billing to Dermatology Associates Of Coastal Carolina. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Dermatology (5) and Nurse Practitioner (2). Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Dermatology Associates Of Coastal Carolina hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 34D2056673) is associated with this NPI, valid through March 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Dermatology Associates Of Coastal Carolina was last updated on September 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.