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PURE DERMATOLOGY & AESTHETICS, PC
NPI 1104176700
Dermatology in Hoover, AL

Active since September 12, 2012
5346 STADIUM TRACE PKWY, SUITE 100, HOOVER, AL 35244(205) 682-8022 Get Directions Write a Review

NPPES record last updated: September 12, 2012. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Pure Dermatology & Aesthetics, Pc NPPES

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

PURE DERMATOLOGY & AESTHETICS, PC (NPI 1104176700) is a healthcare organization registered as a dermatology in Hoover, Alabama and active in the NPI registry since September 2012. The organization lists Elizabeth Shannon Martin, Physician, as its authorized official.

NPPES Registry Identity

NPI1104176700
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NamePURE DERMATOLOGY & AESTHETICS, PC
Location Address5346 STADIUM TRACE PKWY, SUITE 100Hoover, AL 35244-4582
Mailing Address5346 Stadium Trace Pkwy, Suite 100Hoover, AL 35244-4582 · (205) 682-8022
Phone(205) 682-8022
Organization SubpartNo
Authorized OfficialElizabeth Shannon MartinPhysician · (205) 682-8022
Enumeration DateSeptember 12, 2012
✔ NPI 1104176700 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in AL · 21915
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.
5346 STADIUM TRACE PKWY, Hoover, AL 35244
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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)

Pure Dermatology & Aesthetics, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Pure Dermatology & Aesthetics, PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Ross Hendricks, C.R.N.P.
Nurse Practitioner
NPI 1902272339
5346 STADIUM TRACE PKWY STE 100
Hoover, AL 35244
(205) 682-8022
✔ PECOS✔ Accepts MedicareSame address
Elizabeth Martin, M.D.
Dermatology
NPI 1942394689
5346 STADIUM TRACE PKWY SUITE 100
Hoover, AL 35244
(205) 682-8022
✔ PECOS✔ Accepts MedicareSame address

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 for Provider-Performed Microscopy Procedures (PPMP) 01D2048496

Pure Dermatology · Hoover, AL
Expired · Oct 16, 2026
CLIA Number01D2048496
Laboratory TypePhysician Office
Certificate Effective DateOctober 17, 2024
Certificate Expiration DateOctober 16, 2026
Laboratory DirectorElizabeth S. Martin MD
Laboratory Phone(205) 682-8022
Laboratory LocationPure Dermatology5346 Stadium Trace Parkway Suite 100, Hoover, AL 35244
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 Pure Dermatology & Aesthetics, PC's NPI number?

The NPI number for Pure Dermatology & Aesthetics, PC is 1104176700. It was assigned to this organization in the NPPES registry on September 12, 2012.

Where is Pure Dermatology & Aesthetics, PC located?

Pure Dermatology & Aesthetics, PC is located at 5346 Stadium Trace Pkwy Suite 100, Hoover, AL 35244. The listed phone number is (205) 682-8022.

What is Pure Dermatology & Aesthetics, PC's specialty?

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

Is Pure Dermatology & Aesthetics, PC enrolled in Medicare?

Yes. Pure Dermatology & Aesthetics, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pure Dermatology & Aesthetics, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Pure Dermatology & Aesthetics, PC, in Dermatology and Nurse Practitioner. 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. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Pure Dermatology & Aesthetics, PC was last updated on September 12, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.