Dora McIver Broom, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7078 Issued in GA

Practice address

100 Stoneforest Dr Ste 320
Woodstock, GA 30189-4881

Phone

(770) 516-5199

NPI assigned

Jan 14, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atlanta North Dermatology and Skin Care, Inc.Group PAC ID 0648346726, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Atlanta North Dermatology & Skin Care, Inc.

  • Dermatology Physician
  • Woodstock, GA
  • NPI 1215191085
  Medicare reassignment Care Compare group NPD
• Atlanta Personalized Medicine LLC

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1740947035
  NPD (past)
• Atlanta Skin and Aesthetics

  • Procedural Dermatology Physician
  • Atlanta, GA
  • NPI 1780872556
  NPD (past)

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

{
    "created_epoch": "1389657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1144642844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 STONEFOREST DR",
            "address_2": "SUITE 320",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "30189",
            "telephone_number": "770-516-5199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 STONEFOREST DR STE 320",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301894881",
            "telephone_number": "770-516-5199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOM",
        "first_name": "DORA",
        "middle_name": "MCIVER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-14",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alexus Bronson, RBT
• David C Brooks, MA, CCC-SLP
• Alexis K. Brown, MA. LPC
• Ann Marie Brown
• Annie Beatrice Brown, DMD
• Ansley Marie Brown I
• Haley Brown, RBT

• Physician Assistant in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; 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.