NPIMap

Organization Active NPI

Medical Dermatology Specialists,PC

  • Medical Specialty Clinic/Center
  • Sandy Springs, GA
National Provider Identifier
1134544679
Registry record updated Aug 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
50088 Issued in GA
Legal business name
MEDICAL DERMATOLOGY SPECIALISTS,PC
Practice address
5730 Glenridge Dr
Suite T-100
Sandy Springs, GA 30328-6141
Phone
(404) 939-9220
Fax
(404) 939-9221
NPI assigned
Feb 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2016

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

Authorized official

Name
Dr. Jamie D Weisman, M.D.NPI 1033131610
Title
Physician/Owner
Phone
(404) 939-9220

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
Medical Specialty Clinic/Center 261QM2500X 50088 GA Primary

Addresses

Primary practice location

5730 Glenridge Dr
Suite T-100
Sandy Springs, GA 30328-6141

Mailing address

5730 Glenridge Dr
Suite T-100
Sandy Springs, GA 30328-6141
Phone (404) 939-9220

Other identifiers 3

IdentifierTypeStateIssuer
07BBSSTOtherGAMEDICARE ID
202I075875OtherGAMEDICARE PTAN
070016848OtherGAMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140501001470 GA Part B Supplier - Clinic/Group Practice 0244463040 Receives reassigned benefits from 4 practitioners
Practice locations: Atlanta, GA; Sandy Springs, GA

National Provider Directory

National Provider Directory

Locations

5730 Glenridge Dr
Ste T100
Sandy Springs, GA 30328
Phone (404) 939-9220

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1134544679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5730 GLENRIDGE DR",
            "address_2": "SUITE T-100",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303286141",
            "telephone_number": "404-939-9220",
            "fax_number": "404-939-9221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5730 GLENRIDGE DR",
            "address_2": "SUITE T-100",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303286141",
            "telephone_number": "404-939-9220",
            "fax_number": "404-939-9221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL DERMATOLOGY SPECIALISTS,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-20",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "WEISMAN",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "404-939-9220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "GA",
            "license": "50088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "07BBSST",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "202I075875",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "070016848",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy Springs, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.