1. Home
  2. Directory
  3. North Carolina
  4. Boone
  5. Dermatology
  6. NPI Profile

BOONE DERMATOLOGY CLINIC
NPI 1417913260
Dermatology in Boone, NC

Active since April 21, 2006CLIA Certified · 3 labs
169 BIRCH ST, BOONE, NC 28607(828) 264-4553(828) 262-3649 Get Directions Write a Review

NPPES record last updated: April 13, 2015. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Boone Dermatology Clinic NPPES

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

BOONE DERMATOLOGY CLINIC (NPI 1417913260) is a healthcare organization registered as a dermatology in Boone, North Carolina and active in the NPI registry since April 2006. The organization holds 3 active CLIA laboratory certificates and lists Ronald J Stanley, President, as its authorized official.

NPPES Registry Identity

NPI1417913260
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameBOONE DERMATOLOGY CLINIC
Location Address169 BIRCH STBoone, NC 28607-5069
Mailing Address169 Birch StBoone, NC 28607-5069 · (828) 264-4553 · Fax (828) 262-3649
Phone(828) 264-4553
Fax(828) 262-3649
Organization SubpartNo
Authorized OfficialRonald J StanleyPresident · (828) 264-4553
Enumeration DateApril 21, 2006
Last NPPES UpdateApril 13, 2015
✔ NPI 1417913260 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Licenses✔ Licensed in NC · 39986✔ Licensed in NC · 18060✔ Licensed in NC · 25707✔ Licensed in NC · 200000665✔ Licensed in NC · 200500862
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.
169 BIRCH ST, Boone, NC 28607
Open in Google Maps ↗

Other Identifiers 4

Other01404NC · Blue Cross Blue Shield
Medicaid8901404NC
Medicare UPIND33180
Medicare PIN0800NC

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 Blue Cross and Blue Shield of NC.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) 34D0246822

Boone Dermatology Clinic, PA · Boone, NC
Active · expires Jun 9, 2028
CLIA Number34D0246822
Laboratory TypePhysician Office
Certificate Effective DateJune 10, 2026
Certificate Expiration DateJune 9, 2028
Laboratory DirectorAaron A. Westphal
Laboratory Phone(828) 264-4553
Laboratory LocationBoone Dermatology Clinic, PA169 Birch Street, Boone, NC 28607
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.

Certificate of Compliance 34D2052861

Boone Dermatology Clinic, PA · Boone, NC
Active · expires Sep 26, 2027
CLIA Number34D2052861
Laboratory TypePhysician Office
Certificate Effective DateSeptember 27, 2025
Certificate Expiration DateSeptember 26, 2027
Laboratory DirectorBrett T. Summey Jr
Laboratory Phone(828) 264-4553
Laboratory LocationBoone Dermatology Clinic, PA169 Doctors Drive, 2nd Floor, Boone, NC 28607
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.

Certificate of Compliance 34D2300545

Boone Dermatology Clinic · Boone, NC
Active · expires Jul 8, 2027
CLIA Number34D2300545
Laboratory TypePhysician Office
Certificate Effective DateJuly 9, 2025
Certificate Expiration DateJuly 8, 2027
Laboratory DirectorAaron Westphal
Laboratory Phone(828) 264-4553
Laboratory LocationBoone Dermatology Clinic115 Doctors Dr, Boone, NC 28607
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 8

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

AARON A WESTPHAL M.D.
Dermatology (MOHS-Micrographic Surgery)
169 BIRCH ST
BOONE, NC 28607
Watauga County (828) 264-4453
RONALD J STANLEY M.D.
Dermatology
169 BIRCH ST
BOONE, NC 28607
Watauga County (828) 264-4553
GREGORY A. COLLIER PA-C
Physician Assistant
169 BIRCH ST
BOONE, NC 28607
Watauga County (828) 264-4553
MRS. CAROL CONLEY MARKS PHYSICIANS ASSISTANT
Physician Assistant
169 BIRCH ST
BOONE, NC 28607
Watauga County (828) 264-4553
MR. DAVID STANTON WHITTAKER JR. MD
Dermatology
169 BIRCH ST
BOONE, NC 28607
Watauga County (828) 264-4553
BRETT SUMMEY JR. M.D.
Dermatology
169 BIRCH ST
BOONE, NC 28607
Watauga County (828) 264-4553
DR. BRITTAIN HAMMILL TULBERT M.D.
Dermatology
169 BIRCH ST
BOONE, NC 28607
Watauga County (828) 264-4553
ERIN G HOWARD PA
Physician Assistant
169 BIRCH ST
BOONE, NC 28607
Watauga County (828) 264-4553

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 Boone Dermatology Clinic's NPI number?

The NPI number for Boone Dermatology Clinic is 1417913260. It was assigned to this organization in the NPPES registry on April 21, 2006.

Where is Boone Dermatology Clinic located?

Boone Dermatology Clinic is located at 169 Birch St, Boone, NC 28607. The listed phone number is (828) 264-4553.

What is Boone Dermatology Clinic's specialty?

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

Does Boone Dermatology Clinic 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 Boone Dermatology Clinic accept?

Health plans from Blue Cross and Blue Shield of NC list Boone Dermatology Clinic 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 Boone Dermatology Clinic was last updated on April 13, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.