Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

OLIVE BRANCH DERMATOLOGY LLC
NPI 1750197794
Dermatology in Hoover, AL

Active since December 04, 2024CLIA 01D2324954 · Waiver
4721 CHACE CIR, HOOVER, AL 35244(205) 266-9011 Get Directions Write a Review

NPPES record last updated: June 11, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Olive Branch Dermatology Llc NPPES

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

OLIVE BRANCH DERMATOLOGY LLC (NPI 1750197794) is a healthcare organization registered as a dermatology in Hoover, Alabama and active in the NPI registry since December 2024. The organization holds a CLIA Waiver certificate valid through June 3, 2027, maintains a secondary practice location in Tuscaloosa, and lists Amena Raja Alkeswani, Practice Owner, as its authorized official.

NPPES Registry Identity

NPI1750197794
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameOLIVE BRANCH DERMATOLOGY LLC
Location Address4721 CHACE CIRHoover, AL 35244-3700
Mailing AddressPo Box 36263Birmingham, AL 35236-6263 · (205) 266-9011 · Fax (903) 200-1515
Organization SubpartNo
Authorized OfficialAmena Raja AlkeswaniPractice Owner · (727) 504-5883
Enumeration DateDecember 4, 2024
Last NPPES UpdateJune 11, 2026
NPPES CertifiedJune 11, 2026
NPI 1750197794 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
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.
4721 CHACE CIR, Hoover, AL 35244

Secondary Practice Location 1

Location 1500 Towncenter Blvd Ste CTuscaloosa, AL 35406-1847 · Phone (205) 266-9011 · Fax (903) 200-1515

Other Identifiers 1

MedicaidA1254956AL

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

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 Waiver 01D2324954

Olive Branch Dermatology · Hoover, AL
Active · expires Jun 3, 2027
CLIA Number01D2324954
Laboratory TypePhysician Office
Certificate Effective DateJune 4, 2025
Certificate Expiration DateJune 3, 2027
Laboratory DirectorAmena Alkeswani
Laboratory Phone(205) 266-9011
Laboratory LocationOlive Branch Dermatology4721 Chace Cir, Hoover, AL 35244
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

Physician Assistant
4721 CHACE CIR
HOOVER, AL 35244
Nurse Anesthetist, Certified Registered
4721 CHACE CIR
HOOVER, AL 35244
Physician Assistant (Surgical)
4721 CHACE CIR
HOOVER, AL 35244
Thoracic Surgery (Cardiothoracic Vascular Surgery)
4721 CHACE CIR
HOOVER, AL 35244
Physician Assistant (Medical)
4721 CHACE CIR
HOOVER, AL 35244
Dermatology
4721 CHACE CIR
HOOVER, AL 35244
Thoracic Surgery (Cardiothoracic Vascular Surgery)
4721 CHACE CIR
HOOVER, AL 35244

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 Olive Branch Dermatology LLC's NPI number?

The NPI number for Olive Branch Dermatology LLC is 1750197794. It was assigned to this organization in the NPPES registry on December 4, 2024.

Where is Olive Branch Dermatology LLC located?

Olive Branch Dermatology LLC is located at 4721 Chace Cir, Hoover, AL 35244. The listed phone number is (205) 266-9011.

What is Olive Branch Dermatology LLC's specialty?

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

Does Olive Branch Dermatology LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 01D2324954) is associated with this NPI, valid through June 3, 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 Olive Branch Dermatology LLC was last updated on June 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 58 days 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.