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WEST VIRGINIA DERMATOLOGY
NPI 1174881916
Clinic/Center - Medical Specialty in South Charleston, WV

Active since April 30, 2012
4202 MACCORKLE AVE SW STE 200, SOUTH CHARLESTON, WV 25309(304) 925-7546(681) 205-8369 Get Directions Write a Review

NPPES record last updated: January 6, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About West Virginia Dermatology NPPES

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

WEST VIRGINIA DERMATOLOGY (NPI 1174881916) is a healthcare organization registered as a medical specialty in South Charleston, West Virginia and active in the NPI registry since April 2012. The organization lists David W Judy, Owner, as its authorized official.

NPPES Registry Identity

NPI1174881916
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameWEST VIRGINIA DERMATOLOGY AND SKIN SURGERY CENTER
Location Address4202 MACCORKLE AVE SW STE 200South Charleston, WV 25309-1513
Mailing Address4202 Maccorkle Ave Sw Ste 200South Charleston, WV 25309-1513 · (304) 925-7546 · Fax (681) 205-8369
Phone(304) 925-7546
Fax(681) 205-8369
Organization SubpartNo
Authorized OfficialDavid W JudyOwner · (304) 925-7546
Enumeration DateApril 30, 2012
Last NPPES UpdateJanuary 6, 2020
✔ NPI 1174881916 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
License✔ Licensed in WV · 2596
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
4202 MACCORKLE AVE SW STE 200, South Charleston, WV 25309
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Other Names 1

Other NameWest Virginia Dermatology

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Highmark Blue Cross Blue Shield West Virginia.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

West Virginia Dermatology is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to West Virginia Dermatology, which bills Medicare for the services this clinician delivers.

Clinician (1)

David Judy, D.O.
Dermatology
NPI 1619144433
4610 KANAWHA AVE SW SUITE 302
Charleston, WV 25309
(304) 925-7546
✔ PECOS✔ Accepts Medicare0.2 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 West Virginia Dermatology And Skin Surgery Center's NPI number?

The NPI number for West Virginia Dermatology And Skin Surgery Center is 1174881916. It was assigned to this organization in the NPPES registry on April 30, 2012. The provider is also known as West Virginia Dermatology.

Where is West Virginia Dermatology And Skin Surgery Center located?

West Virginia Dermatology And Skin Surgery Center is located at 4202 Maccorkle Ave SW Ste 200, South Charleston, WV 25309. The listed phone number is (304) 925-7546.

What is West Virginia Dermatology And Skin Surgery Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Is West Virginia Dermatology And Skin Surgery Center enrolled in Medicare?

Yes. West Virginia Dermatology And Skin Surgery Center is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through West Virginia Dermatology And Skin Surgery Center?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to West Virginia Dermatology And Skin Surgery Center. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does West Virginia Dermatology And Skin Surgery Center accept?

Health plans from Highmark Blue Cross Blue Shield West Virginia list West Virginia Dermatology And Skin Surgery Center as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for West Virginia Dermatology And Skin Surgery Center was last updated on January 6, 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.