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SKIN CANCER AND COSMETIC DERMATOLOGY CENTER PC
NPI 1063715423
Dermatology in Kimball, TN

Active since December 07, 2010CLIA 11D0917334 · Certificate of Compliance
400 DIXIE LEE CENTER RD, SUITE C, KIMBALL, TN 37347(706) 277-7311(706) 272-3512 Get Directions Write a Review

NPPES record last updated: January 17, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Skin Cancer And Cosmetic Dermatology Center Pc NPPES

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

SKIN CANCER AND COSMETIC DERMATOLOGY CENTER PC (NPI 1063715423) is a healthcare organization registered as a dermatology in Kimball, Tennessee and active in the NPI registry since December 2010. The organization holds a CLIA Certificate of Compliance certificate valid through August 10, 2027 and lists Kelley Finnell, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1063715423
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSKIN CANCER AND COSMETIC DERMATOLOGY CENTER PC
Location Address400 DIXIE LEE CENTER RD, SUITE CKimball, TN 37347-5672
Mailing Address1107 Memorial Dr, Suite 201Dalton, GA 30720-8668 · (706) 277-7311 · Fax (706) 272-3512
Phone(706) 277-7311
Fax(706) 272-3512
Organization SubpartYes
Authorized OfficialKelley FinnellPractice Manager · (706) 277-7311
Enumeration DateDecember 7, 2010
Last NPPES UpdateJanuary 17, 2011
✔ NPI 1063715423 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
400 DIXIE LEE CENTER RD, Kimball, TN 37347
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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

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 11D0917334

Skin Cancer & Cosmetic Dermatology Ctr · Dalton, GA
Active · expires Aug 10, 2027
CLIA Number11D0917334
Laboratory TypePhysician Office
Certificate Effective DateAugust 11, 2025
Certificate Expiration DateAugust 10, 2027
Laboratory DirectorJohn Y. Chung
Laboratory Phone(706) 277-7311
Laboratory LocationSkin Cancer & Cosmetic Dermatology Ctr1107 Memorial Drive, Suite 201, Dalton, GA 30720
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RACHEL CARTER PT
Physical Therapist
400 DIXIE LEE CENTER RD, SUITE A
KIMBALL, TN 37347
Marion County (423) 837-7536
DR. DENNIS RAY BLEVINS JR. DPT
Physical Therapist
400 DIXIE LEE CENTER RD, SUITE A
KIMBALL, TN 37347
Marion County (423) 837-7536
SOUTHERN REHAB & AQUATICS
Physical Therapist
400 DIXIE LEE CENTER RD, SUITE A
KIMBALL, TN 37347
Marion County (423) 837-7536
TRACY DEWAYNE KENNEMORE PT
Physical Therapist
400 DIXIE LEE CENTER RD
KIMBALL, TN 37347
Marion County (423) 837-7536

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 Skin Cancer And Cosmetic Dermatology Center PC's NPI number?

The NPI number for Skin Cancer And Cosmetic Dermatology Center PC is 1063715423. It was assigned to this organization in the NPPES registry on December 7, 2010.

Where is Skin Cancer And Cosmetic Dermatology Center PC located?

Skin Cancer And Cosmetic Dermatology Center PC is located at 400 Dixie Lee Center Rd Suite C, Kimball, TN 37347. The listed phone number is (706) 277-7311.

What is Skin Cancer And Cosmetic Dermatology Center PC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Skin Cancer And Cosmetic Dermatology Center PC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 11D0917334) is associated with this NPI, valid through August 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Skin Cancer And Cosmetic Dermatology Center PC was last updated on January 17, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.