MID-SOUTH DERMATOLOGY, PC
NPI 1720011679
Dermatology in Bartlett, TN
About Mid-south Dermatology, Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MID-SOUTH DERMATOLOGY, PC (NPI 1720011679) is a healthcare organization registered as a dermatology in Bartlett, Tennessee and active in the NPI registry since July 2006. The organization holds a CLIA Certificate of Compliance certificate valid through June 8, 2027 and lists Malika Tuli, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mid-south Dermatology, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Mid-South Dermatology, PC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 of Compliance 44D0686235
Mid-South Dermatology, PC · Bartlett, TNFrequently 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 Mid-South Dermatology, PC's NPI number?
The NPI number for Mid-South Dermatology, PC is 1720011679. It was assigned to this organization in the NPPES registry on July 7, 2006.
Where is Mid-South Dermatology, PC located?
Mid-South Dermatology, PC is located at 6644 Summer Knoll Cir, Bartlett, TN 38134. The listed phone number is (901) 372-4545.
What is Mid-South Dermatology, PC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Mid-South Dermatology, PC enrolled in Medicare?
Yes. Mid-South Dermatology, PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Mid-South Dermatology, PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians reassign their Medicare billing to Mid-South Dermatology, PC, in Dermatology and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Mid-South Dermatology, PC hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 44D0686235) is associated with this NPI, valid through June 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Mid-South Dermatology, PC was last updated on April 22, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Mid-South Dermatology, Pc · NPI 1720011679
Dermatology organization in Bartlett, Tennessee. Organization record, active in the CMS NPPES registry since July 7, 2006.
## Identity
- **NPI:** 1720011679 (Entity type: Organization)
- **Enumerated:** July 7, 2006
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Malika Tuli, OWNER
## Practice location
- **Address:** 6644 SUMMER KNOLL CIR, Bartlett, TN 38134-2875
- **Phone:** (901) 372-4545 · **Fax:** (901) 372-4310
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (2), Nurse Practitioner (2); 3 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 22, 2021
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1720011679) · Data from the CMS NPPES public registry.