MECKLENBURG MEDICAL GROUP (MMG) – NPI #1396061347
Dermatology

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.

MECKLENBURG MEDICAL GROUP (MMG) is a dermatologist located in INDIAN LAND, SC. NPPES has assigned the NPI number 1396061347 to MECKLENBURG MEDICAL GROUP (MMG) on April 15, 2010. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “MECKLENBURG MEDICAL GROUP (MMG)” is a dba name, the actual legal business name for this organization is MECKLENBURG MEDICAL GROUP. This provider is also associated with 2 additional names listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207N00000X from the Health Care Provider Taxonomy code set, which is classified as Dermatology. Bear in mind that having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

The NPI profile was previously updated about 3 years ago on Mar 09, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MECKLENBURG MEDICAL GROUP (MMG) below.

NPI Profile for
MECKLENBURG MEDICAL GROUP

NPI Number
1396061347
Enumeration Date

(more than 16 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MECKLENBURG MEDICAL GROUP
Doing Business As (dba): MECKLENBURG MEDICAL GROUP (MMG)
Other name(s)
All associated names:
Doing Business As (dba)
Atrium Health Primary Care Carolina Lakes Internal Medicine
Doing Business As (dba)
Mecklenburg Medical Group (MMG)
Primary location
7666 CHARLOTTE HWY
STE 200
INDIAN LAND, SC 29707-7000
Phone: (803) 431-8225 Fax:
Mailing address
PO BOX 19305
CHARLOTTE, NC 28219-9305
Phone: (704) 631-0002 Fax:
Organization Subpart
Yes - MECKLENBURG MEDICAL GROUP (MMG) is subpart of another organization.
Authorized Official
SCOTT RISSMILLER
ENTERPRISE EVP
Phone: (704) 355-8675
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

View All Endpoint(s)
Endpoint
https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service
Endpoint type
CONNECT URL
Endpoint Description
2.16.840.1.113883.3.667.2
Content Type
Affiliation
Y
Endpoint Location
100 N 6TH ST STE 900A,
MINNEAPOLIS, MN 77025-1669

Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
Content Type
Affiliation
Y
Endpoint Location
7666 CHARLOTTE HWY,
INDIAN LAND, SC 77025-1669