SUNRISE DERMATOLOGY
NPI 1477708642
Dermatology - MOHS-Micrographic Surgery in Vestavia Hls, AL

Q: What is the provider's specialty?

The provider's specialty is Dermatology with taxonomy code 207ND0101X and a focus in MOHS-Micrographic Surgery.

Active since December 01, 2008CLIA Certified · 6 labs

1940 STONEGATE DR STE 130, VESTAVIA HLS, AL 35242(205) 977-9876(205) 977-9976 Get Directions Write a Review

NPPES record last updated: June 25, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 25, 2024, Sep 2, 2020, Aug 8, 2018 (3 updates tracked since 2018).

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About Sunrise Dermatology NPPES

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

SUNRISE DERMATOLOGY (NPI 1477708642) is a healthcare organization registered as a mohs-micrographic surgery in Vestavia Hls, Alabama and active in the NPI registry since December 2008. The organization holds 6 active CLIA laboratory certificates and lists Karen Lake, Administration, as its authorized official.

NPPES Registry Identity

NPI1477708642

Entity TypeOrganization

Primary Taxonomy207ND0101X

Legal Business NameAQUA DERMATOLOGY OF ALABAMA PC

Location Address1940 STONEGATE DR STE 130Vestavia Hls, AL 35242

Mailing Address1940 Stonegate Dr Ste 130Vestavia Hls, AL 35242-2541 · (205) 977-9876 · Fax (205) 977-9976

Phone(205) 977-9876

Fax(205) 977-9976

Organization SubpartNo

Authorized OfficialKaren LakeAdministration · (205) 977-9786

Enumeration DateDecember 1, 2008

Last NPPES UpdateJune 25, 20243 updates tracked since enumeration

NPPES CertifiedJune 25, 2024

✔ NPI 1477708642 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207ND0101X

License✔ Licensed in AL · 20579

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 · License 20579 (AL)

Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X · License 20579 (AL)

1940 STONEGATE DR STE 130, Vestavia Hls, AL 35242

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Other Names 3

Doing Business AsSunrise Dermatology

Doing Business AsSurgical Dermatology Group

Doing Business AsTrue Dermatology

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Magnolia Health, Ambetter Health, Ambetter of Alabama and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 7

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) 01D2345097

Aqua Dermatology Of Alabama, PC Dba Surgical Dermatology Group · Jasper, AL

Active · expires Jun 3, 2028

CLIA Number01D2345097

Laboratory TypePhysician Office

Certificate Effective DateJune 4, 2026

Certificate Expiration DateJune 3, 2028

Laboratory DirectorDr. Brian King

Laboratory Phone(205) 977-9876

Laboratory LocationAqua Dermatology Of Alabama, PC Dba Surgical Dermatology Group1440 Jones Diary Road, Jasper, AL 35501

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 of Compliance 01D1016733

Aqua Dermatology Of Alabama PC Surgical Dermatology Group - Huntsville · Huntsville, AL

Active · expires Apr 13, 2028

CLIA Number01D1016733

Laboratory TypePhysician Office

Certificate Effective DateApril 14, 2026

Certificate Expiration DateApril 13, 2028

Laboratory DirectorDr. Christopher B. Harmon

Laboratory Phone(205) 977-9876

Laboratory LocationAqua Dermatology Of Alabama PC Surgical Dermatology Group - Huntsville4810 Whitesport Circle SW Suite 110, Huntsville, AL 35801

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 01D1016731

Aqua Dermatology Of Alabama PC Surgical Dermatology Group · Montgomery, AL

Active · expires Mar 28, 2028

CLIA Number01D1016731

Laboratory TypePhysician Office

Certificate Effective DateMarch 29, 2026

Certificate Expiration DateMarch 28, 2028

Laboratory DirectorDr. Christopher B. Harmon

Laboratory Phone(205) 977-9876

Laboratory LocationAqua Dermatology Of Alabama PC Surgical Dermatology Group7300 Halcyon Summitt Drive, Montgomery, AL 36117

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 01D2018153

Aqua Dermatology Of Alabama PC Surgical Dermatology Group · Birmingham, AL

Active · expires Nov 2, 2027

CLIA Number01D2018153

Laboratory TypePhysician Office

Certificate Effective DateNovember 3, 2025

Certificate Expiration DateNovember 2, 2027

Laboratory DirectorDr. Jonathan A. Cappel

Laboratory Phone(205) 977-9876

Laboratory LocationAqua Dermatology Of Alabama PC Surgical Dermatology Group1401 Edwards Lake Road, Birmingham, AL 35235

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 01D2129536

Aqua Dermatology Of Alabama PC Surgical Dermatology Grp Dothan · Dothan, AL

Active · expires Sep 12, 2027

CLIA Number01D2129536

Laboratory TypePhysician Office

Certificate Effective DateSeptember 13, 2025

Certificate Expiration DateSeptember 12, 2027

Laboratory DirectorDr. Jonathan A. Cappel

Laboratory Phone(205) 977-9876

Laboratory LocationAqua Dermatology Of Alabama PC Surgical Dermatology Grp Dothan2431 West Main Street Suite 501, Dothan, AL 36301

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 01D1092927

Aqua Dermatology Of Alabama PC Surgical Dermatology Group · Vestavia Hills, AL

Active · expires Jun 22, 2027

CLIA Number01D1092927

Laboratory TypePhysician Office

Certificate Effective DateJune 23, 2025

Certificate Expiration DateJune 22, 2027

Laboratory DirectorDr. Christopher B. Harmon

Laboratory Phone(205) 977-9876

Laboratory LocationAqua Dermatology Of Alabama PC Surgical Dermatology Group1940 Stonegate Drive, Suite 130, Vestavia Hills, AL 35242

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 12

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

MIRANDA P FRITH PA-C

Physician Assistant (Surgical)