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SANFORD DERMATOLOGY PLLC
NPI 1205240868
Dermatology in Sanford, NC

Active since June 11, 2014CLIA Certified · 3 labs
1911 K M WICKER MEMORIAL DR, SANFORD, NC 27330(919) 775-7926(919) 718-0092 Get Directions Write a Review

NPPES record last updated: November 8, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 8, 2024, Jan 2, 2024, Jan 28, 2019 (3 updates tracked since 2019).

About Sanford Dermatology Pllc NPPES

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

SANFORD DERMATOLOGY PLLC (NPI 1205240868) is a healthcare organization registered as a dermatology in Sanford, North Carolina and active in the NPI registry since June 2014. The organization holds 3 active CLIA laboratory certificates and lists Jeffrey D. Queen, Manager, as its authorized official.

NPPES Registry Identity

NPI1205240868
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSANFORD DERMATOLOGY PLLC
Location Address1911 K M WICKER MEMORIAL DRSanford, NC 27330-5070
Mailing Address4700 Exchange Ct Ste 110Boca Raton, FL 33431-4450 · (561) 314-2000
Phone(919) 775-7926
Fax(919) 718-0092
Organization SubpartNo
Authorized OfficialJeffrey D. QueenManager · (561) 314-2000
Enumeration DateJune 11, 2014
Last NPPES UpdateNovember 8, 20243 updates tracked since enumeration
NPPES CertifiedNovember 8, 2024
✔ NPI 1205240868 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
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.
Also ListedPhysician AssistantTaxonomy 363A00000X
1911 K M WICKER MEMORIAL DR, Sanford, NC 27330
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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 MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 3

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) 34D2268942

Sanford Dermatology · Lillington, NC
Active · expires Sep 19, 2026
CLIA Number34D2268942
Laboratory TypePhysician Office
Certificate Effective DateSeptember 20, 2024
Certificate Expiration DateSeptember 19, 2026
Laboratory DirectorDawn E. Kleinman
Laboratory Phone(919) 775-7926
Laboratory LocationSanford Dermatology100 S 10th Street, Lillington, NC 27546
CLIA data matches this NPI record on: 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.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 34D2268946

Sanford Dermatology · Pittsboro, NC
Active · expires Sep 19, 2026
CLIA Number34D2268946
Laboratory TypePhysician Office
Certificate Effective DateSeptember 20, 2024
Certificate Expiration DateSeptember 19, 2026
Laboratory DirectorDawn E. Kleinman
Laboratory Phone(919) 775-7926
Laboratory LocationSanford Dermatology959 East Street Suite B, Pittsboro, NC 27312
CLIA data matches this NPI record on: 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.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 34D0238673

Sanford Dermatology · Sanford, NC
Active · expires Aug 31, 2026
CLIA Number34D0238673
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorDawn E. Kleinman
Laboratory Phone(919) 775-7926
Laboratory LocationSanford Dermatology1911 Km Wicker Memorial Drive, Sanford, NC 27330
CLIA data matches this NPI record on: 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.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WILLIAM E. HALL MD, P.A.
Clinic/Center
1911 K M WICKER MEMORIAL DR
SANFORD, NC 27330
Lee County (919) 775-1000
IAN PERKINS PA
Physician Assistant
1911 K M WICKER MEMORIAL DR
SANFORD, NC 27330
Lee County (919) 439-9251
KATHERINE SERAFEN KOONCE PA-C
Physician Assistant
1911 K M WICKER MEMORIAL DR
SANFORD, NC 27330
Lee County (910) 439-9251
MS. CHASSIDY STARR YOUNG PA
Physician Assistant
1911 K M WICKER MEMORIAL DR
SANFORD, NC 27330
Lee County (919) 775-1000
CENTRAL CAROLINA PHYSICIANS - SANDHILLS, LLC
Family Medicine
1911 K M WICKER MEMORIAL DR
SANFORD, NC 27330
Lee County (919) 775-1000
JOHN DAVIDSON CHEESBOROUGH MD
Dermatology
1911 K M WICKER MEMORIAL DR
SANFORD, NC 27330
Lee County (919) 775-7926
DAWN ELIZABETH KLEINMAN MD
Dermatology
1911 K M WICKER MEMORIAL DR
SANFORD, NC 27330
Lee County (919) 775-7926
DLP CENTRAL CAROLINA PHYSICIAN PRACTICES LLC
Family Medicine
1911 K M WICKER MEMORIAL DR
SANFORD, NC 27330
Lee County (615) 920-7000

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 Sanford Dermatology PLLC's NPI number?

The NPI number for Sanford Dermatology PLLC is 1205240868. It was assigned to this organization in the NPPES registry on June 11, 2014.

Where is Sanford Dermatology PLLC located?

Sanford Dermatology PLLC is located at 1911 K M Wicker Memorial Dr, Sanford, NC 27330. The listed phone number is (919) 775-7926.

What is Sanford Dermatology PLLC's specialty?

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

Does Sanford Dermatology PLLC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Sanford Dermatology PLLC accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee, AmeriHealth Caritas Next and Blue Cross and Blue Shield of NC list Sanford Dermatology PLLC 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 Sanford Dermatology PLLC was last updated on November 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.