Southern Dermatology Medical LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

SOUTHERN DERMATOLOGY MEDICAL LLC

Practice address

3555 Richland Ave W Ste 174
Aiken, SC 29801-6410

Phone

(803) 335-0066

Fax

(762) 224-2177

NPI assigned

Feb 11, 2021

Organization subpart

No

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

Authorized official

Name

Briana Brown, DONPI 1164835104

Title

Dermatologist

Phone

(412) 995-0025

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, SC2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00281

Practitioners 14

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

• Briana Brown, D.O.

  • Dermatology Physician
  • Evans, GA
  • NPI 1164835104

  SC

  Medicare reassignment Care Compare group NPD Authorized official
• Kamaria Nicole Nelson, M.D.

  • Dermatology Physician
  • Conway, SC
  • NPI 1952836165

  GA

  Medicare reassignment Care Compare group NPD
• Cassondra Vahling, PA

  • Physician Assistant
  • Aiken, SC
  • NPI 1417570235
  Medicare reassignment Care Compare group NPD
• Kierston Dorothy Holifield, P.A.

  • Physician Assistant
  • Evans, GA
  • NPI 1598916272

  SC

  Medicare reassignment Care Compare group
• Kacee Camp Morris, PA-C

  • Physician Assistant
  • Evans, GA
  • NPI 1376090571

  SC

  Medicare reassignment Care Compare group
• Amy Spillers Williams, FNP

  • Family Nurse Practitioner
  • Evans, GA
  • NPI 1215765839

  SC

  Medicare reassignment Care Compare group
• Rachel Falkner, M.D.

  • Dermatology Physician
  • Birmingham, AL
  • NPI 1457790214

  GA

  Medicare reassignment NPD
• Jarod Franklin Bailey, D.O.

  • Internal Medicine Physician
  • Valdosta, GA
  • NPI 1649432733
  NPD (past)
• Alberto Garcia, MD

  • Family Medicine Physician
  • Hahira, GA
  • NPI 1518047547
  NPD (past)
• Ava Dawn Greene, FNP-C

  • Family Nurse Practitioner
  • Moultrie, GA
  • NPI 1992283097
  NPD (past)
• Thomas Wayne Hart, NP-BC

  • Nurse Practitioner
  • Tallahassee, FL
  • NPI 1417474180
  NPD (past)
• Darin J Melvin, NP

  • Adult Health Nurse Practitioner
  • Valdosta, GA
  • NPI 1386074680
  NPD (past)

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736726400000",
    "number": "1265024186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4158 WASHINGTON RD STE 9",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094720",
            "telephone_number": "706-760-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 RICHLAND AVE W STE 174",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298016410",
            "telephone_number": "803-335-0066",
            "fax_number": "762-224-2177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4150 Washington Rd Ste 6",
            "address_purpose": "LOCATION",
            "city": "Evans",
            "state": "GA",
            "postal_code": "308094722",
            "country_code": "US",
            "telephone_number": "706-760-0013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHERN DERMATOLOGY MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-11",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "BRIANA",
        "authorized_official_title_or_position": "DERMATOLOGIST",
        "authorized_official_telephone_number": "412-995-0025",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Aiken, SC
• Providers in Aiken, SC by specialty
• Dermatology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; 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.

Verify at the official NPI Registry.