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HIGHLANDS DERMATOLOGY AND SURGICAL ASSOCIATES
NPI 1093151045
Specialist in Cookeville, TN

Active since May 17, 2013CLIA 44D0865928 · Certificate of Compliance
112 N WALNUT AVE, COOKEVILLE, TN 38501(931) 520-1414(931) 520-1246 Get Directions Write a Review

NPPES record last updated: May 17, 2013. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Highlands Dermatology And Surgical Associates NPPES

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

HIGHLANDS DERMATOLOGY AND SURGICAL ASSOCIATES (NPI 1093151045) is a healthcare organization registered as a specialist in Cookeville, Tennessee and active in the NPI registry since May 2013. The organization holds a CLIA Certificate of Compliance certificate valid through March 30, 2027 and lists Richard S Hall, Owner, as its authorized official.

NPPES Registry Identity

NPI1093151045
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameHIGHLANDS DERMATOLOGY AND SURGICAL ASSOCIATES
Location Address112 N WALNUT AVECookeville, TN 38501-2554
Mailing AddressPo Box 1210Cookeville, TN 38503-1210 · (931) 520-1414 · Fax (931) 520-1246
Phone(931) 520-1414
Fax(931) 520-1246
Organization SubpartNo
Authorized OfficialRichard S HallOwner · (931) 520-1414
Enumeration DateMay 17, 2013
✔ NPI 1093151045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in TN · 18375
Definition
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.
112 N WALNUT AVE, Cookeville, TN 38501
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Other Identifiers 1

Medicare PIN370850TN

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)

Highlands Dermatology And Surgical Associates is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Highlands Dermatology And Surgical Associates, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Richard Hall, M.D.
Dermatology
NPI 1952368870
112 N WALNUT AVE
Cookeville, TN 38501
(931) 520-1414
✔ PECOS✔ Accepts MedicareSame address
Christie Hummel, FNP-BC
Nurse Practitioner
NPI 1962740217
112 N. WALNUT AVE
Cookeville, TN 38501
(931) 520-1414
✔ PECOS✔ Accepts MedicareSame address
Tina Kelly, MSN, FNP-C
Nurse Practitioner
NPI 1871277285
MCCOY MEDICAL 1324 SOUTH HOME STREET
Union City, TN 38261
(731) 885-8881
✔ PECOS✔ Accepts Medicare202 mi
Rochelle Lamb, APN
Nurse Practitioner
NPI 1427023837
5911 N HONORE AVE STE 210
Sarasota, FL 34243
(941) 308-7546
✔ PECOS✔ Accepts Medicare631 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 44D0865928

Highlands Dermatology & Surgical Associates · Cookeville, TN
Active · expires Mar 30, 2027
CLIA Number44D0865928
Laboratory TypePhysician Office
Certificate Effective DateMarch 31, 2025
Certificate Expiration DateMarch 30, 2027
Laboratory DirectorDr. Richard S. Hall
Laboratory Phone(931) 520-1414
Laboratory LocationHighlands Dermatology & Surgical Associates112 N Walnut Ave, Cookeville, TN 38501
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.

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 Highlands Dermatology And Surgical Associates's NPI number?

The NPI number for Highlands Dermatology And Surgical Associates is 1093151045. It was assigned to this organization in the NPPES registry on May 17, 2013.

Where is Highlands Dermatology And Surgical Associates located?

Highlands Dermatology And Surgical Associates is located at 112 N Walnut Ave, Cookeville, TN 38501. The listed phone number is (931) 520-1414.

What is Highlands Dermatology And Surgical Associates's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Highlands Dermatology And Surgical Associates enrolled in Medicare?

Yes. Highlands Dermatology And Surgical Associates is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Highlands Dermatology And Surgical Associates?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Highlands Dermatology And Surgical Associates. 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 Nurse Practitioner (3) and Dermatology (1). Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Highlands Dermatology And Surgical Associates hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 44D0865928) is associated with this NPI, valid through March 30, 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 Highlands Dermatology And Surgical Associates was last updated on May 17, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.