NPIMap

Organization Active NPI

North Georgia Dermatology, P.C.

  • Dermatology Physician
  • Lawrenceville, GA
National Provider Identifier
1154483139
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
NORTH GEORGIA DERMATOLOGY, P.C.
Practice address
771 Old Norcross Rd
Suite 260
Lawrenceville, GA 30046-4386
Phone
(770) 962-5040
Fax
(770) 962-5056
NPI assigned
Dec 15, 2006
Last updated
Dec 28, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Authorized official

Name
Ms. Jennifer White
Title
Office Manager
Phone
(770) 962-5040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

771 Old Norcross Rd
Suite 260
Lawrenceville, GA 30046-4386

Mailing address

771 Old Norcross Rd
Suite 260
Lawrenceville, GA 30046-4386
Phone (770) 962-5040

National Provider Directory

National Provider Directory

Locations

2089 Teron Trce
Ste 200
Dacula, GA 30019
Phone (770) 848-5300

2089 Teron Trce
Ste 220
Dacula, GA 30019
Phone (470) 443-4439

2108 Teron Trce
Ste 100
Dacula, GA 30019
Phone (678) 318-8020

565 Old Norcross Rd
Lawrenceville, GA 30046
Phone (770) 962-5040

771 Old Norcross Rd
Ste 2
Lawrenceville, GA 30046

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293494400000",
    "number": "1154483139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 OLD NORCROSS RD",
            "address_2": "SUITE 260",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464386",
            "telephone_number": "770-962-5040",
            "fax_number": "770-962-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 OLD NORCROSS RD",
            "address_2": "SUITE 260",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464386",
            "telephone_number": "770-962-5040",
            "fax_number": "770-962-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH GEORGIA DERMATOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2010-12-28",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-962-5040",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.