Healthcare Provider Details

I. General information

NPI: 1912822362
Provider Name (Legal Business Name): APEX DERMATOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9298 APISON PIKE STE 100
OOLTEWAH TN
37363-7268
US

IV. Provider business mailing address

PO BOX 118
OOLTEWAH TN
37363-0118
US

V. Phone/Fax

Practice location:
  • Phone: 423-458-2863
  • Fax:
Mailing address:
  • Phone: 423-458-2863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: CATHY A MACKNET KASNER
Title or Position: MD/PRACTICE OWNER
Credential: MD
Phone: 909-214-7771