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MIDTOWN DERMATOLOGY, PC
NPI 1205242252
Dermatology in Raleigh, NC

Active since July 09, 2014CLIA 34D2083080 · Microscopy
5904 SIX FORKS RD STE 211, RALEIGH, NC 27609(984) 242-0510(984) 242-0520 Get Directions Write a Review

NPPES record last updated: November 16, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 16, 2022, Jul 2, 2020, Jul 2, 2019 (3 updates tracked since 2019).

About Midtown Dermatology, Pc NPPES

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

MIDTOWN DERMATOLOGY, PC (NPI 1205242252) is a healthcare organization registered as a dermatology in Raleigh, North Carolina and active in the NPI registry since July 2014. The organization holds a CLIA Microscopy certificate valid through August 26, 2026, maintains a secondary practice location in Rocky Mount, and lists Beth Anne Schulz-butulis, President, as its authorized official.

NPPES Registry Identity

NPI1205242252
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameMIDTOWN DERMATOLOGY, PC
Location Address5904 SIX FORKS RD STE 211Raleigh, NC 27609-8228
Mailing Address5904 Six Forks Rd Ste 211Raleigh, NC 27609-8228 · (984) 242-0510 · Fax (984) 242-0520
Phone(984) 242-0510
Fax(984) 242-0520
Organization SubpartNo
Authorized OfficialBeth Anne Schulz-butulisPresident · (984) 242-0510
Enumeration DateJuly 9, 2014
Last NPPES UpdateNovember 16, 20223 updates tracked since enumeration
NPPES CertifiedNovember 16, 2022
✔ NPI 1205242252 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in NC · 203528
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.
5904 SIX FORKS RD STE 211, Raleigh, NC 27609
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Secondary Practice Location 1

Location 14056 Capital DrRocky Mount, NC 27804-3123 · Phone (984) 242-0510 · Fax (984) 242-0520

Other Identifiers 2

OtherDV9975Railroad Medicare Ptan
OtherD895Medicare Ptan

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

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) 34D2083080

Midtown Dermatology PC · Raleigh, NC
Active · expires Aug 26, 2026
CLIA Number34D2083080
Laboratory TypePhysician Office
Certificate Effective DateAugust 27, 2024
Certificate Expiration DateAugust 26, 2026
Laboratory DirectorBeth Schulz-Butulis
Laboratory Phone(984) 242-0510
Laboratory LocationMidtown Dermatology PC5904 Six Forks Road, Suite 211, Raleigh, NC 27609
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.

Other Providers at the Same Location NPPES 4

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

DR. BETH ANNE SCHULZ-BUTULIS D.O.
Dermatology
5904 SIX FORKS RD STE 211
RALEIGH, NC 27609
Wake County (984) 242-0510
MS. SARAH ASHLYN DJALI PURVIS PA-C
Physician Assistant
5904 SIX FORKS RD STE 211
RALEIGH, NC 27609
Wake County (984) 242-0510
JACLYN RHEA SCHAVONE PA-C
Physician Assistant
5904 SIX FORKS RD STE 211
RALEIGH, NC 27609
Wake County (984) 242-0510
MS. SANDRIVETTE JOHNSON FNP-C
Nurse Practitioner
5904 SIX FORKS RD STE 211
RALEIGH, NC 27609
Wake County (984) 242-0510

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 Midtown Dermatology, PC's NPI number?

The NPI number for Midtown Dermatology, PC is 1205242252. It was assigned to this organization in the NPPES registry on July 9, 2014.

Where is Midtown Dermatology, PC located?

Midtown Dermatology, PC is located at 5904 Six Forks Rd Ste 211, Raleigh, NC 27609. The listed phone number is (984) 242-0510.

What is Midtown Dermatology, PC's specialty?

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

Does Midtown Dermatology, PC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 34D2083080) is associated with this NPI, valid through August 26, 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 Midtown Dermatology, PC was last updated on November 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.