NPIMap

Organization Active NPI

Dermatology Associates of Georgia, LLC

  • Specialist
  • Decatur, GA
National Provider Identifier
1063560803
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
DERMATOLOGY ASSOCIATES OF GEORGIA, LLC
Practice address
1951 Clairmont Rd
Decatur, GA 30033-3415
Phone
(404) 321-4600
Fax
(404) 320-0987
NPI assigned
Jan 8, 2007
Last updated
Feb 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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

Authorized official

Name
Dr. Marcus R Stonecipher, MDNPI 1801904354
Title
Managing Member
Phone
(404) 321-4600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

1951 Clairmont Rd
Decatur, GA 30033-3415

Mailing address

1951 Clairmont Rd
Decatur, GA 30033-3415
Phone (404) 321-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040825001091 GA Part B Supplier - Clinic/Group Practice 3678547569 Receives reassigned benefits from 22 practitioners
Practice locations: Decatur, GA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0686603Dermatology Associates of Georgia LLC1951 Clairmont Road, Decatur, GA 30033ComplianceNov 17, 2027

National Provider Directory

National Provider Directory

Locations

1951 Clairmont Rd
Decatur, GA 30033
Phone (404) 321-4600

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328832000000",
    "number": "1063560803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 CLAIRMONT RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333415",
            "telephone_number": "404-321-4600",
            "fax_number": "404-320-0987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 CLAIRMONT RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333415",
            "telephone_number": "404-321-4600",
            "fax_number": "404-320-0987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2012-02-10",
        "status": "A",
        "authorized_official_last_name": "STONECIPHER",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "404-321-4600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; 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.