SOUTH COAST DERMATOLOGY LLC
NPI 1114567377
Nurse Practitioner - Adult Health in Coos Bay, OR
About South Coast Dermatology Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTH COAST DERMATOLOGY LLC (NPI 1114567377) is a healthcare organization registered as an adult health in Coos Bay, Oregon and active in the NPI registry since January 2020. The organization holds a CLIA Microscopy certificate valid through December 2, 2026 and lists William Wallace Webster, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
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) 38D2203358
South Coast Dermatology, LLC · Coos Bay, OROther Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 South Coast Dermatology LLC's NPI number?
The NPI number for South Coast Dermatology LLC is 1114567377. It was assigned to this organization in the NPPES registry on January 15, 2020.
Where is South Coast Dermatology LLC located?
South Coast Dermatology LLC is located at 620 Commercial Ave, Coos Bay, OR 97420. The listed phone number is (541) 808-3860.
What is South Coast Dermatology LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.
Does South Coast Dermatology LLC hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 38D2203358) is associated with this NPI, valid through December 2, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for South Coast Dermatology LLC was last updated on January 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# South Coast Dermatology Llc · NPI 1114567377
Adult Health organization in Coos Bay, Oregon. Organization record, active in the CMS NPPES registry since January 15, 2020.
## Identity
- **NPI:** 1114567377 (Entity type: Organization)
- **Enumerated:** January 15, 2020
- **Primary specialty:** Nurse Practitioner - Adult Health · taxonomy 363LA2200X
- **Organization subpart:** No
- **Authorized official:** William Webster, OWNER
## Practice location
- **Address:** 620 COMMERCIAL AVE, Coos Bay, OR 97420-1846
- **Phone:** (541) 808-3860
## Record status
- **NPPES last updated:** January 15, 2020
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1114567377) · Data from the CMS NPPES public registry.