Active NPI
Atlanta West Dermatology & Surgery Center PC
- Dermatology Physician
- Austell, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 028477
- Legal business name
- ATLANTA WEST DERMATOLOGY & SURGERY CENTER PC
- Practice address
- 1550 Mulkey Rd
Austell, GA 30106-1112 - Phone
- (770) 732-1137
- Fax
- (770) 732-2081
- NPI assigned
- Jan 2, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Christy Hall
- Title
- Office Manager
- Phone
- (770) 732-1137
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 028477 | GA | Primary |
Addresses
Primary practice location
1550 Mulkey Rd
Austell, GA 30106-1112
Mailing address
1550 Mulkey Rd
Austell, GA 30106-1112
Phone (770) 732-1137
Other practice location 1
2850 Paces Ferry Rd SE Ste 450
Atlanta, GA 30339-5725
Phone (770) 732-1137
Other names 1
- Atlanta West Dermatology PC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D0724381 | Atlanta West Dermatology PC | Compliance | Jul 31, 2026 |
| 11D2335064 | Atlanta West Dermatology PC | Registration | Dec 4, 2027 |
National Provider Directory
National Provider DirectoryLocations
3400 Old Milton Pkwy
Ste C555
Alpharetta, GA 30005
Phone (404) 446-3200
2850 Paces Ferry Rd SE
Ste 450
Atlanta, GA 30339
Phone (770) 732-1137
1700 Hospital South Dr
Ste 101
Austell, GA 30106
Phone (770) 732-1137
Practitioners & affiliated clinicians
Practitioners 8
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Dermatology Physician
- Austell, GA
- NPI 1669817011
-
- MOHS-Micrographic Surgery Physician
- Austell, GA
- NPI 1295295848
-
- Pediatric Dermatology Physician
- Austell, GA
- NPI 1912432659
-
- Dermatology Physician
- Austell, GA
- NPI 1710220249
-
- MOHS-Micrographic Surgery Physician
- Austell, GA
- NPI 1720189293
-
- Medical Physician Assistant
- Austell, GA
- NPI 1184781999
-
- Nurse Practitioner
- Austell, GA
- NPI 1912487786
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1773273600000",
"number": "1174680979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1550 MULKEY RD",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301061112",
"telephone_number": "770-732-1137",
"fax_number": "770-732-2081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1550 MULKEY RD",
"city": "AUSTELL",
"state": "GA",
"postal_code": "301061112",
"telephone_number": "770-732-1137",
"fax_number": "770-732-2081"
}
],
"practiceLocations": [
{
"address_1": "2850 Paces Ferry Rd SE Ste 450",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303395725",
"country_code": "US",
"telephone_number": "770-732-1137",
"fax_number": "770-732-2081",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "ATLANTA WEST DERMATOLOGY & SURGERY CENTER PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-02",
"last_updated": "2026-03-12",
"certification_date": "2026-03-12",
"status": "A",
"authorized_official_last_name": "HALL",
"authorized_official_first_name": "CHRISTY",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "770-732-1137"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dermatology",
"state": "GA",
"license": "028477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Atlanta West Dermatology PC",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Austell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; 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.