Sanford Dermatology PLLC
NPI 1205240868 · Dermatology Physician · Sanford, NC
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Sanford Dermatology PLLC is a Dermatology Physician organization in Sanford, NC (NPI 1205240868).
Provider details
- NPI number
- 1205240868
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jeffrey Queen, Manager(561) 314-2000
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Physician Assistant363A00000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 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
- 2014-06-11
- Last updated
- 2024-11-08
- Certified
- 2024-11-08
Frequently asked questions
- What is Sanford Dermatology PLLC's NPI number?
- Sanford Dermatology PLLC's National Provider Identifier (NPI) is 1205240868, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Sanford Dermatology PLLC?
- Sanford Dermatology PLLC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Sanford Dermatology PLLC located?
- Sanford Dermatology PLLC's practice location on file with NPPES is 1911 K M Wicker Memorial Dr, Sanford, NC 27330-5070.
- What is Sanford Dermatology PLLC's phone number?
- The practice phone number listed in the NPPES registry for Sanford Dermatology PLLC is (919) 775-7926.
- Does Sanford Dermatology PLLC accept Medicare?
- Sanford Dermatology PLLC 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 Sanford Dermatology PLLC?
- The authorized official listed on Sanford Dermatology PLLC's NPPES record is Jeffrey Queen, Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Sanford Dermatology PLLC's NPI active?
- Yes — Sanford Dermatology PLLC's NPI (1205240868) is active in the NPPES registry as of the last update on 2024-11-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.