EVANS DERMATOLOGY, LLC
NPI 1083862577
Specialist in Evans, GA
NPI Status: Active since September 09, 2008
Contact Information
902 PONDER PLACE CT
EVANS, GA
ZIP 30809
Phone: (706) 922-3376
Fax: (706) 922-5643
- Organization
- Specialist
- Accepts Insurance
- CLIA Number: 11D2041542
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 05-23-2026
About EVANS DERMATOLOGY, LLC
This page provides the complete NPI Profile along with additional information for Evans Dermatology, Llc, a provider established in Evans, Georgia operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1083862577 assigned on September 2008. The practitioner's primary taxonomy code is 174400000X with license number 0576116 (GA). The provider is registered as an organization and their NPI record was last updated 18 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Frances Florentino Md (Member)
- NPI
- 1083862577
- Provider Name
- EVANS DERMATOLOGY, LLC
- Entity Type
- Organization
- Location Address
- 902 PONDER PLACE CT EVANS, GA 30809
- Location Phone
- (706) 922-3376
- Location Fax
- (706) 922-5643
- Mailing Address
- 902 PONDER PLACE CT EVANS, GA 30809
- Mailing Phone
- (706) 922-3376
- Mailing Fax
- (706) 922-5643
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-09-2008
- Last Update Date
- 11-07-2008
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- License No.
- 0576116
- License State
- GA
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Direction Bronze 1 - POS
- Blue Direction Silver 1 - POS
- Blue Direction Silver 1 + Adult Vision - POS
- Blue Direction Silver 2 - POS
- Blue Direction Standard Expanded Bronze - POS
- Blue Direction Standard Gold - POS
- Blue Direction Standard Silver - POS
- Blue VirtuConnect Bronze 1 - EPO
- Blue VirtuConnect Gold 1 - EPO
- Blue VirtuConnect Silver 1 - EPO
- BlueEssentials Bronze 4 - EPO
- BlueEssentials Bronze 6 - EPO
- BlueEssentials Gold 1 - EPO
- BlueEssentials Gold 5 - EPO
- BlueEssentials Silver 14 - EPO
- BlueEssentials Silver 14 + Adult Vision - EPO
- BlueEssentials Silver 40 - EPO
- BlueEssentials Standard Expanded Bronze - EPO
- BlueEssentials Standard Gold - EPO
- BlueEssentials Standard Silver - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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 this NPI number is:
- CLIA Number
- 11D2041542
- Facility Type
- Physician Office
- Certificate Effective Date
- May 24, 2024
- Certificate Expiration Date
- May 23, 2026
- Laboratory Director
- FRANCES T. FLORENTINO
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Evans Dermatology, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1083862577, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 63 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 10 providers are registered at the same or a nearby location.
EVANS, GA 30809
EVANS, GA 30809
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1083862577, enumerated as an "organization" on September 09, 2008.
The provider is located at 902 PONDER PLACE CT EVANS, GA 30809 and the phone number is (706) 922-3376.
Specialist with taxonomy code 174400000X.
The provider might be accepting Accepts: BlueCross BlueShield of South Carolina. Please consult your insurance carrier or call the provider to verify.
