Johns Creek Dermatology and Family Medicine, P.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

061526 Issued in GA

Legal business name

JOHNS CREEK DERMATOLOGY AND FAMILY MEDICINE, P.C.

Practice address

6300 Hospital Pkwy
Ste 100
Johns Creek, GA 30097

Phone

(770) 771-6591

Fax

(770) 771-6599

NPI assigned

Nov 11, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Shereen Timani

Title

Owner

Phone

(770) 771-6591

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DGBGAA

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Springs Dermatology, LLC

  • Dermatopathology Physician
  • Sandy Springs, GA
  • NPI 1679158885
  NPPES parent name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ahmad Charkawi, MD

  • Family Medicine Physician
  • Johns Creek, GA
  • NPI 1982602074
  Medicare reassignment Care Compare group NPD
• Shereen Timani-Charkawi, M.D.

  • Dermatology Physician
  • Johns Creek, GA
  • NPI 1851505077
  Medicare reassignment Care Compare group NPD
• Anna Leigh Vonck, PA-C

  • Physician Assistant
  • Duluth, GA
  • NPI 1023619129
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286236800000",
    "number": "1053565580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 HOSPITAL PKWY",
            "address_2": "STE 100",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "770-771-6591",
            "fax_number": "770-771-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 HOSPITAL PKWY",
            "address_2": "STE 100",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "30097",
            "telephone_number": "770-771-6591",
            "fax_number": "770-771-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNS CREEK DERMATOLOGY AND FAMILY MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-11",
        "last_updated": "2010-10-05",
        "status": "A",
        "authorized_official_last_name": "TIMANI",
        "authorized_official_first_name": "SHEREEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-771-6591",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "GA",
            "license": "061526",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "GA",
            "license": "061526",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "061566",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "GA",
            "license": "061566",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. AHMAD CHARKAWI",
            "identifier": "1982602074",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR SHEREEN TIMANI",
            "identifier": "1851505077",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "437442038A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nida Suleman Jiwani, DO
• JL Health Center LLC (Active Care Atlanta)
• Johns Creek Center for Pain and Spine
• Johns Creek Dental Excellence, P.C.
• Johns Creek Dentistry, P.C.
• Johns Creek House Call Providers LLC
• Johns Creek Neonatology
• Kendra Johnson-Cummings
• Ayanna Johnson-Reid
• Morgan Leigh Richburg Johnson, APRN

• Dermatology Physician in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.