Henry Grady Skelton III, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

052870 Issued in GA

Practice address

1777 Montreal Cir
Anatomic Pathology
Tucker, GA 30084-6802

Phone

(678) 406-1509

Fax

(770) 621-7530

NPI assigned

Mar 14, 2008

Last updated

Sep 25, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

Medical College of Georgia School of Medicine, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chestatee Pathology Associates, PCGroup PAC ID 0840260097, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chestatee Pathology Associates, PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Smyrna, GA
  • NPI 1568403988
  Medicare reassignment Care Compare group NPD
• Dermpath and Derm Consultants

  • Clinical Medical Laboratory
  • Decatur, GA
  • NPI 1841632783
  NPD

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443139200000",
    "number": "1053582353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 MONTREAL CIR",
            "address_2": "ANATOMIC PATHOLOGY",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846802",
            "telephone_number": "678-406-1509",
            "fax_number": "770-621-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 MONTREAL CIR",
            "address_2": "ANATOMIC PATHOLOGY",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846802",
            "telephone_number": "678-406-1509",
            "fax_number": "770-621-7530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKELTON",
        "first_name": "HENRY",
        "middle_name": "GRADY",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-14",
        "last_updated": "2015-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "VA",
            "license": "0101032713",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "AL",
            "license": "00023737",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "SC",
            "license": "26892",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "NC",
            "license": "200400265",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "PA",
            "license": "MD247781",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "FL",
            "license": "ME98759",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "GA",
            "license": "052870",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "052870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Herbert Alfred Singleton, M.D.
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• Rae Kocen Sirott, LCSW
• Ashley M. Skidmore, LCSW
• Sleep Better Atlanta, LLC (Alpha Sleep Center)
• Smiley's Hair Clinic LLC (Smiley's Hair Clinic & Mastectomy Boutique)
• Smiley's Hair Clinic LLC
• Betty Smith-Weldon, DC

• Anatomic Pathology & Clinical Pathology Physician in Tucker, GA
• Providers in Tucker, GA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.