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COOSA RIVER DERMATOLOGY, INC
NPI 1447003579
Dermatology - MOHS-Micrographic Surgery in Pell City, AL

Active since April 09, 2024
1242 MARTIN ST S STE B, PELL CITY, AL 35128(205) 514-1664 Get Directions Write a Review

NPPES record last updated: April 9, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Coosa River Dermatology, Inc NPPES

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

COOSA RIVER DERMATOLOGY, INC (NPI 1447003579) is a healthcare organization registered as a mohs-micrographic surgery in Pell City, Alabama and active in the NPI registry since April 2024. The organization lists Kelsey Real Kennedy, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1447003579
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameCOOSA RIVER DERMATOLOGY, INC
Location Address1242 MARTIN ST S STE BPell City, AL 35128-2310
Mailing AddressPo Box 932Trussville, AL 35173-0932
Phone(205) 514-1664
Organization SubpartNo
Authorized OfficialKelsey Real KennedyPresident/ceo · (205) 514-1664
Enumeration DateApril 9, 2024
NPPES CertifiedApril 9, 2024
✔ NPI 1447003579 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
1242 MARTIN ST S STE B, Pell City, AL 35128
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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

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 Coosa River Dermatology, Inc's NPI number?

The NPI number for Coosa River Dermatology, Inc is 1447003579. It was assigned to this organization in the NPPES registry on April 9, 2024.

Where is Coosa River Dermatology, Inc located?

Coosa River Dermatology, Inc is located at 1242 Martin St S Ste B, Pell City, AL 35128. The listed phone number is (205) 514-1664.

What is Coosa River Dermatology, Inc's specialty?

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

When was this NPI record last updated?

The NPPES record for Coosa River Dermatology, Inc was last updated on April 9, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.