MCCOMB SKIN CLINIC PA
NPI 1740448653
Dermatology in Mccomb, MS

NPI Status: Active since May 28, 2008

Contact Information

136 MARION AVE
MCCOMB, MS
ZIP 39648
Phone: (601) 684-3210
Fax: (601) 684-3319

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  • Organization
  • Dermatology
  • CLIA Number: 25D0320030
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 02-02-2027

About MCCOMB SKIN CLINIC PA

This page provides the complete NPI Profile along with additional information for Mccomb Skin Clinic Pa, a provider established in Mccomb, Mississippi operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1740448653 assigned on May 2008. The practitioner's primary taxonomy code is 207N00000X with license number 7285 (MS). The provider is registered as an organization and their NPI record was last updated 18 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mrs. Linda Young Brock (Office Administrator)

NPI
1740448653
Provider Name
MCCOMB SKIN CLINIC PA
Entity Type
Organization
Location Address
136 MARION AVE MCCOMB, MS 39648
Location Phone
(601) 684-3210
Location Fax
(601) 684-3319
Mailing Address
136 MARION AVE MCCOMB, MS 39648
Mailing Phone
(601) 684-3210
Mailing Fax
(601) 684-3319
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-28-2008
Last Update Date
07-01-2008
Code Navigator

A dermatologist like Mccomb Skin Clinic Pa is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dermatology

Taxonomy Code
207N00000X
Type
Allopathic & Osteopathic Physicians
License No.
7285
License State
MS
Taxonomy Description
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.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. LINDA YOUNG BROCK

Authorized Official Title
OFFICE ADMINISTRATOR
Authorized Official Phone
(601) 684-3210

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
=========OTHER (01)MSSTATE OF MS CLAIMS ADMINISTRATOR
C48072MEDICARE UPIN (02)MS 
=========OTHER (01)MSBLUE CROSS BLUE SHIELD OF MS
09014899MEDICAID (05)MS 
512G700186MEDICARE PIN (08)MS 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
25D0320030
Facility Type
Physician Office
Certificate Effective Date
February 03, 2025
Certificate Expiration Date
February 02, 2027
Laboratory Director
JAMES M. BROCK JR
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Mccomb Skin Clinic Pa in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1740448653, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
4
Doubled → 8
Pos 4
0
Unchanged
Pos 5
4
Doubled → 8
Pos 6
4
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
6
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 4 → 8 8 → 16 → 7 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 8 + 0 + 8 + 4 + 1 + 6 + 6 + 1 + 0 + 24 = 67

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1740448653.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
136 MARION AVE
MCCOMB, MS 39648
Dermatology
136 MARION AVE
MCCOMB, MS 39648
Nurse Practitioner
136 MARION AVE
MCCOMB, MS 39648
Dermatology
136 MARION AVE
MCCOMB, MS 39648

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1740448653, enumerated as an "organization" on May 28, 2008.

The provider is located at 136 MARION AVE MCCOMB, MS 39648 and the phone number is (601) 684-3210.

Dermatology with taxonomy code 207N00000X.

The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.