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FORA DERMATOLOGY PLLC
NPI 1366086597
Dermatology - MOHS-Micrographic Surgery in Mooresville, NC

Active since October 31, 2019CLIA Certified · 3 labs
118 GATEWAY BLVD STE A, MOORESVILLE, NC 28117(704) 230-1302(704) 230-1284 Get Directions Write a Review

NPPES record last updated: June 4, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 4, 2023, Apr 20, 2021, Jan 26, 2021 and 6 more (9 updates tracked since 2019).

About Fora Dermatology Pllc NPPES

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

FORA DERMATOLOGY PLLC (NPI 1366086597), doing business as Pc Dermatology Pllc, is a healthcare organization registered as a mohs-micrographic surgery in Mooresville, North Carolina and active in the NPI registry since October 2019. The organization holds 3 active CLIA laboratory certificates, maintains a secondary practice location in Mooresville, and lists Bishr Al Dabagh, Owner, as its authorized official.

NPPES Registry Identity

NPI1366086597
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameFORA DERMATOLOGY PLLC
Location Address118 GATEWAY BLVD STE AMooresville, NC 28117-6542
Mailing Address118 Gateway Blvd Ste AMooresville, NC 28117-6542 · (704) 230-1302 · Fax (704) 230-1284
Phone(704) 230-1302
Fax(704) 230-1284
Organization SubpartNo
Authorized OfficialBishr Al DabaghOwner · (704) 230-1302
Enumeration DateOctober 31, 2019
Last NPPES UpdateJune 4, 20239 updates tracked since enumeration
NPPES CertifiedJune 4, 2023
✔ NPI 1366086597 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
Definition
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Also ListedDermatologyTaxonomy 207N00000X
Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X
118 GATEWAY BLVD STE A, Mooresville, NC 28117
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Other Names 1

Former Legal Business NamePc Dermatology Pllc

Secondary Practice Location 1

Location 1128 Medical Park Rd Ste 201Mooresville, NC 28117-8579 · Phone (704) 230-1302 · Fax (704) 230-1284

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 of Compliance 34D2180053

Fora Dermatology · Mooresville, NC
Active · expires Mar 2, 2027
CLIA Number34D2180053
Laboratory TypePhysician Office
Certificate Effective DateMarch 3, 2025
Certificate Expiration DateMarch 2, 2027
Laboratory DirectorBishr A. Al-Dabagh
Laboratory Phone(704) 230-1302
Laboratory LocationFora Dermatology118 Gateway Boulevard, Suite A, Mooresville, NC 28117
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 34D2301206

Fora Dermatology PLLC · Mooresville, NC
Active · expires Mar 21, 2028
CLIA Number34D2301206
Laboratory TypePhysician Office
Certificate Effective DateMarch 22, 2026
Certificate Expiration DateMarch 21, 2028
Laboratory DirectorBishr A. Al-Dabagh
Laboratory Phone(704) 230-1302
Laboratory LocationFora Dermatology PLLC653 Bluefield Road Suite G, Mooresville, NC 28117
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 34D2321019

Fora Dermatology · Taylorsville, NC
Active · expires Mar 26, 2027
CLIA Number34D2321019
Laboratory TypePhysician Office
Certificate Effective DateMarch 27, 2025
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorBishr A. Al-Dabagh
Laboratory Phone(704) 230-1302
Laboratory LocationFora Dermatology1668 Nc Highway 16 South, Taylorsville, NC 28681
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 6

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

BISHR AL DABAGH MD
Dermatology (MOHS-Micrographic Surgery)
118 GATEWAY BLVD STE A
MOORESVILLE, NC 28117
Iredell County (704) 230-1302
MS. KIMBERLY SUMNER MESSINA PA-C
Physician Assistant (Medical)
118 GATEWAY BLVD STE A
MOORESVILLE, NC 28117
Iredell County (704) 230-1302
DR. JOHN SCOTT KEADLE DDS
Dentist (General Practice)
118 GATEWAY BLVD STE A
MOORESVILLE, NC 28117
Iredell County (704) 639-1330
MISS GARYN SCOUT SCHMIDT PA-C
Physician Assistant
118 GATEWAY BLVD STE A
MOORESVILLE, NC 28117
Iredell County (704) 230-1302
MARY ELIZABETH WEAVER COREY PA-C
Physician Assistant
118 GATEWAY BLVD STE A
MOORESVILLE, NC 28117
Iredell County (704) 230-1302
LINA SIHAMATH RICKS PA-C
Physician Assistant
118 GATEWAY BLVD STE A
MOORESVILLE, NC 28117
Iredell County (704) 230-1302

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 Fora Dermatology PLLC's NPI number?

The NPI number for Fora Dermatology PLLC is 1366086597. It was assigned to this organization in the NPPES registry on October 31, 2019. The provider was formerly known as PC Dermatology PLLC.

Where is Fora Dermatology PLLC located?

Fora Dermatology PLLC is located at 118 Gateway Blvd Ste A, Mooresville, NC 28117. The listed phone number is (704) 230-1302.

What is Fora Dermatology PLLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Does Fora 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 Fora 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 Fora 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 Fora Dermatology PLLC was last updated on June 4, 2023. 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.