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ANDERSON DERMATOLOGY AND SKIN SURGERY CENTER
NPI 1790340750
Dermatology in Easley, SC

Active since May 06, 2019CLIA 42D2153392 · Microscopy
112 JOHN ST STE 105, EASLEY, SC 29640(864) 855-2052(864) 855-2518 Get Directions Write a Review

NPPES record last updated: May 6, 2019. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Anderson Dermatology And Skin Surgery Center NPPES

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

ANDERSON DERMATOLOGY AND SKIN SURGERY CENTER (NPI 1790340750) is a healthcare organization registered as a dermatology in Easley, South Carolina and active in the NPI registry since May 2019. The organization holds a CLIA Microscopy certificate valid through August 23, 2028, maintains a secondary practice location in Anderson, and lists Crystal Greer, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1790340750
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameANDERSON DERMATOLOGY AND SKIN SURGERY CENTER
Location Address112 JOHN ST STE 105Easley, SC 29640-1405
Mailing Address1501 N Main StAnderson, SC 29621-4734 · (864) 716-0063 · Fax (864) 716-0073
Phone(864) 855-2052
Fax(864) 855-2518
Organization SubpartYesParent: Anderson Dermatology And Skin Surgery Center, Llc
Authorized OfficialCrystal GreerCredentialing Specialist · (864) 716-0063
Enumeration DateMay 6, 2019
✔ NPI 1790340750 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.
112 JOHN ST STE 105, Easley, SC 29640
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Other Names 1

Other NameAnderson Dermatology And Skin Surgery Center, Llc (easley)

Secondary Practice Location 1

Location 11501 N Main StAnderson, SC 29621-4734 · Phone (864) 716-0063 · Fax (864) 716-0073

Other Identifiers 1

MedicaidGP3575SC

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 for Provider-Performed Microscopy Procedures (PPMP) 42D2153392

Anderson Dermatology & Skin Surgery Center LLC · Easley, SC
Active · expires Aug 23, 2028
CLIA Number42D2153392
Laboratory TypePhysician Office
Certificate Effective DateAugust 24, 2026
Certificate Expiration DateAugust 23, 2028
Laboratory DirectorDr. Theresa G. Knoepp
Laboratory Phone(864) 855-2052
Laboratory LocationAnderson Dermatology & Skin Surgery Center LLC101 Richard St, Easley, SC 29640
CLIA data matches this NPI record on: 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.

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 Anderson Dermatology And Skin Surgery Center's NPI number?

The NPI number for Anderson Dermatology And Skin Surgery Center is 1790340750. It was assigned to this organization in the NPPES registry on May 6, 2019. The provider is also known as Anderson Dermatology and Skin Surgery Center, LLC (Easley).

Where is Anderson Dermatology And Skin Surgery Center located?

Anderson Dermatology And Skin Surgery Center is located at 112 John St Ste 105, Easley, SC 29640. The listed phone number is (864) 855-2052.

What is Anderson Dermatology And Skin Surgery Center's specialty?

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

Does Anderson Dermatology And Skin Surgery Center hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 42D2153392) is associated with this NPI, valid through August 23, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Anderson Dermatology And Skin Surgery Center was last updated on May 6, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.