1. Home
  2. Directory
  3. Florida
  4. New Smyrna Beach
  5. Dermatology
  6. NPI Profile

DAVIS DERMATOLOGY, PA
NPI 1104330224
Dermatology - Procedural Dermatology in New Smyrna Beach, FL

Active since November 28, 2017
504 S ORANGE ST, NEW SMYRNA BEACH, FL 32168(386) 423-2218 Get Directions Write a Review

NPPES record last updated: June 16, 2018. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 16, 2018, Dec 19, 2017, Nov 28, 2017 (3 updates tracked since 2017).

About Davis Dermatology, Pa NPPES

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

DAVIS DERMATOLOGY, PA (NPI 1104330224) is a healthcare organization registered as a procedural dermatology in New Smyrna Beach, Florida and active in the NPI registry since November 2017. The organization lists Valerie Davis, Owner, as its authorized official.

NPPES Registry Identity

NPI1104330224
Entity TypeOrganization
Primary Taxonomy207NS0135X
Legal Business NameDAVIS DERMATOLOGY, PA
Location Address504 S ORANGE STNew Smyrna Beach, FL 32168-7319
Mailing Address504 S Orange StNew Smyrna Beach, FL 32168-7319 · (386) 423-2218
Phone(386) 423-2218
Organization SubpartNo
Authorized OfficialValerie DavisOwner · (386) 423-2218
Enumeration DateNovember 28, 2017
Last NPPES UpdateJune 16, 20183 updates tracked since enumeration
✔ NPI 1104330224 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207NS0135X
License✔ Licensed in FL · ME51662
Definition
Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).
504 S ORANGE ST, New Smyrna Beach, FL 32168
Open in Google Maps ↗

Other Identifiers 1

Medicaid047966700FL

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)

Davis Dermatology, Pa 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 Davis Dermatology, PA, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Valerie Davis, M.D.
Dermatology
NPI 1457332819
504 S ORANGE ST
New Smyrna Beach, FL 32168
(386) 423-2218
✔ PECOS✔ Accepts MedicareSame address
Theresa Holt, APRN
Nurse Practitioner
NPI 1902482722
1131 S ORANGE AVE
Orlando, FL 32806
(941) 444-0011
✔ PECOS✔ Accepts Medicare44 mi

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

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 Davis Dermatology, PA's NPI number?

The NPI number for Davis Dermatology, PA is 1104330224. It was assigned to this organization in the NPPES registry on November 28, 2017.

Where is Davis Dermatology, PA located?

Davis Dermatology, PA is located at 504 S Orange St, New Smyrna Beach, FL 32168. The listed phone number is (386) 423-2218.

What is Davis Dermatology, PA's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

Is Davis Dermatology, PA enrolled in Medicare?

Yes. Davis Dermatology, PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Davis Dermatology, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Davis Dermatology, PA, 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, 1 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 Davis Dermatology, PA was last updated on June 16, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.