Tricities Skin and Cancer
NPI 1295824415ActiveOrganization· Dermatology· Johnson City, TN
Dermatology in Johnson City, Tennessee, registered in NPPES in October 2006. The authorized official on file is Brenda Sue Stufflestreet, Practice Administrator. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1295824415 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 12, 2006 |
| Last updated in NPPES | Mar 17, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
| Dermatology, MOHS-Micrographic Surgery | 207ND0101X | — | — |
| Dermatology, Dermatopathology | 207ND0900X | — | — |
| Dermatology, Procedural Dermatology | 207NS0135X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TN) |
|---|
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