ESTHETICS CENTER FOR DERMATOLOGY PA
NPI 1891879615
Specialist in Charlotte, NC

NPI Status: Active since October 25, 2006

Contact Information

353 CLEMENT AVE
CHARLOTTE, NC
ZIP 28204
Phone: (704) 370-2700
Fax: (704) 370-2702

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  • Organization
  • Specialist
  • CLIA Number: 34D1052338
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 03-22-2028

About ESTHETICS CENTER FOR DERMATOLOGY PA

This page provides the complete NPI Profile along with additional information for Esthetics Center For Dermatology Pa, a provider established in Charlotte, North Carolina operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1891879615 assigned on October 2006. The practitioner's primary taxonomy code is 174400000X with license number 127728 (NC). The provider is registered as an organization and their NPI record was last updated 6 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 Peggy A. Fuller M.d. (Owner)

NPI
1891879615
Provider Name
ESTHETICS CENTER FOR DERMATOLOGY PA
Entity Type
Organization
Location Address
353 CLEMENT AVE CHARLOTTE, NC 28204
Location Phone
(704) 370-2700
Location Fax
(704) 370-2702
Mailing Address
353 CLEMENT AVE CHARLOTTE, NC 28204
Mailing Phone
(704) 370-2700
Mailing Fax
(704) 370-2702
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-25-2006
Last Update Date
08-22-2020
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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

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
License No.
127728
License State
NC
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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.

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

PEGGY A. FULLER M.D.

Authorized Official Title
OWNER
Authorized Official Phone
(704) 370-2700

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
34D1052338
Facility Type
Physician Office
Certificate Effective Date
March 23, 2026
Certificate Expiration Date
March 22, 2028
Laboratory Director
PEGGY A. FULLER
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Esthetics Center For Dermatology 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 1891879615, we treat the final digit (5) 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 75. The final step is to find the difference between that total and the next multiple of ten (80 - 75 = 5).

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
8
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
1
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
7
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
6
Unchanged
Pos 9
1
Doubled → 2
Check
5
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 9 → 18 → 9 8 → 16 → 7 9 → 18 → 9 1 → 2

Step 2: Add all digits plus the NPI constant

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

2 + 8 + 1 + 8 + 1 + 1 + 6 + 7 + 1 + 8 + 6 + 2 + 24 = 75

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

The next multiple of ten after 75 is 80. The difference is the calculated check digit.

80 - 75 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1891879615.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Specialist
353 CLEMENT AVE
CHARLOTTE, NC 28204

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1891879615, enumerated as an "organization" on October 25, 2006.

The provider is located at 353 CLEMENT AVE CHARLOTTE, NC 28204 and the phone number is (704) 370-2700.

Specialist with taxonomy code 174400000X.