Polley Clinic of Dermatology & Dermatologic Surgery
NPI 1104847714 · Dermatopathology Physician · Wilson, NC
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Polley Clinic of Dermatology & Dermatologic Surgery is a Dermatopathology Physician organization in Wilson, NC (NPI 1104847714).
Provider details
- NPI number
- 1104847714
- Entity type
- Organization
- Primary specialty
- Dermatopathology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kelli Newman, Credentialing Specialist(252) 668-7026
- License
- 27881 (NC)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-07-21
- Last updated
- 2021-08-04
- Certified
- 2020-08-06
Frequently asked questions
- What is Polley Clinic of Dermatology & Dermatologic Surgery's NPI number?
- Polley Clinic of Dermatology & Dermatologic Surgery's National Provider Identifier (NPI) is 1104847714, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Polley Clinic of Dermatology & Dermatologic Surgery?
- Polley Clinic of Dermatology & Dermatologic Surgery is classified in the NPPES registry as Dermatopathology Physician (Allopathic & Osteopathic Physicians).
- Where is Polley Clinic of Dermatology & Dermatologic Surgery located?
- Polley Clinic of Dermatology & Dermatologic Surgery's practice location on file with NPPES is 1806 Glendale Dr Sw, Wilson, NC 27893-4402.
- What is Polley Clinic of Dermatology & Dermatologic Surgery's phone number?
- The practice phone number listed in the NPPES registry for Polley Clinic of Dermatology & Dermatologic Surgery is (252) 243-0566.
- Does Polley Clinic of Dermatology & Dermatologic Surgery accept Medicare?
- Polley Clinic of Dermatology & Dermatologic Surgery is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Polley Clinic of Dermatology & Dermatologic Surgery?
- The authorized official listed on Polley Clinic of Dermatology & Dermatologic Surgery's NPPES record is Kelli Newman, Credentialing Specialist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Polley Clinic of Dermatology & Dermatologic Surgery's NPI active?
- Yes — Polley Clinic of Dermatology & Dermatologic Surgery's NPI (1104847714) is active in the NPPES registry as of the last update on 2021-08-04.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.