Individual provider Active NPI

Katherine Alice Rupley

  • Dermatology Physician
  • Atlanta, GA
National Provider Identifier
1134549199
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
83076 Issued in GA
Practice address
5505 Peachtree Dunwoody Rd Ste 412
Atlanta, GA 30342
Phone
(404) 459-9177
Fax
(404) 389-0400
NPI assigned
Apr 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 25MA10288400 NJ
Dermatology Physician 207N00000X 83076 GA Primary

Addresses

Primary practice location

5505 Peachtree Dunwoody Rd Ste 412
Atlanta, GA 30342

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other practice location 1

5246 Brittany Dr
Baton Rouge, LA 70808-9136
Phone (225) 803-1419

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Katherine.Rupley@forefrontdermatology.emadirect.md

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190828004192 GA Practitioner - Dermatology 3779832837 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Louisiana State University School of Medicine in New Orleans, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Georgia PCGroup PAC ID 6800885757, 56 clinicians

Practice addresses (Care Compare)

835 Cogburn Ave NW
Suite 100
Marietta, GA 30060-1008
Phone (770) 422-5557

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision24
Removal of skin lesions494
Removal or shaving of skin growth1-10
Skin biopsy308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
83076GAMDDermatology Physician
25MA10288400NJMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatopathology Lab of Skin Cancer Specialists, P.C. CurrentSince May 1, 2024 Accepting new patients
Aqua Dermatology of Georgia PC Dermatology CurrentSince May 1, 2024 Accepting new patients
Goodman Dermatology, PC Dermatology CurrentSince May 1, 2023 Accepting new patients

Locations

1255 Friendship Rd
Ste 120
Braselton, GA 30517
Phone (470) 201-7777

4700 Nelson Brogdon Blvd
Ste 125
Buford, GA 30518
Phone (470) 242-0725

1839 Buford Hwy
Ste 100
Buford, GA 30518
Phone (678) 450-9933

470 Northside Cherokee Blvd
Ste 170
Canton, GA 30115
Phone (770) 721-9540

2870 Ronald Reagan Blvd
Ste 103
Cumming, GA 30041
Phone (248) 601-4900

2000 Howard Farm Dr
Ste 320
Cumming, GA 30041
Phone (404) 847-4180

5983 Highway 53 E
Ste 200
Dawsonville, GA 30534
Phone (770) 754-0787

1163 Johnson Ferry Rd
Ste 250
Marietta, GA 30068
Phone (770) 321-1001

835 Cogburn Ave NW
Ste 250
Marietta, GA 30060
Phone (770) 422-8815

835 Cogburn Ave NW
Ste 100
Marietta, GA 30060
Phone (770) 422-5557

5185 Peachtree Pkwy
Ste 240
Peachtree Corners, GA 30092
Phone (470) 242-0716

2500 Hospital Blvd
Ste 280
Roswell, GA 30076
Phone (770) 754-0787

1357 Hembree Rd
Ste 250
Roswell, GA 30076
Phone (770) 475-7550

4298 Atlanta Rd SE
Ste 320
Smyrna, GA 30080
Phone (470) 242-0717

2001 Professional Way
Ste 250
Woodstock, GA 30188
Phone (770) 754-0787

Interoperability endpoints

  • Direct secure messaging: katherine.rupley@affiliateddermatologists.chartmakerdirect.com
  • Direct secure messaging: krupley@directaddress.net
  • Direct secure messaging: katherine.rupley@forefrontdermatology.emadirect.md

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1134549199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 PEACHTREE DUNWOODY RD STE 412",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "404-459-9177",
            "fax_number": "404-389-0400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5246 Brittany Dr",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708089136",
            "country_code": "US",
            "telephone_number": "225-803-1419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUPLEY",
        "first_name": "KATHERINE",
        "middle_name": "ALICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-17",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NJ",
            "license": "25MA10288400",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "83076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Katherine.Rupley@forefrontdermatology.emadirect.md",
            "affiliation": "N",
            "address_1": "5505 Peachtree Dunwoody Rd Ste 412",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.