Skin Cancer Center of North Georgia PC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

SKIN CANCER CENTER OF NORTH GEORGIA PC

Practice address

405 Fannin Industrial Park
Blue Ridge, GA 30513-4191

Phone

(352) 259-6553

NPI assigned

Oct 31, 2023

Last updated

Nov 9, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary Barber, MDNPI 1003812207

Title

President

Phone

(352) 259-6553

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

Practitioners 16

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.

• Mary F Barber, M.D.

  • MOHS-Micrographic Surgery Physician
  • Summerfield, FL
  • NPI 1003812207

  Dermatology, GA

  Medicare reassignment Care Compare group NPD Authorized official
• Kayla Renee Boggs, FNP-C

  • Nurse Practitioner
  • Blue Ridge, GA
  • NPI 1326811258
  Medicare reassignment Care Compare group NPD
• Tanya Hartman, APRN, FNP-C

  • Nurse Practitioner
  • Blue Ridge, GA
  • NPI 1841812922
  Medicare reassignment Care Compare group NPD
• Carla Renee Bailey, PA-C

  • Physician Assistant
  • Summerfield, FL
  • NPI 1366771115
  NPD
• Neil Sandhu, MD

  • Dermatology Physician
  • Orange City, FL
  • NPI 1134389364
  NPD
• Casandra L Slavens, ARNP

  • Dermatology Physician
  • Summerfield, FL
  • NPI 1548596083
  NPD
• Rebecca Stoner Thornhill, M.D.

  • MOHS-Micrographic Surgery Physician
  • Summerfield, FL
  • NPI 1164957916

  Dermatology

  NPD
• Robert Grant Hollenbeck, M.D.

  • Anesthesiology Physician
  • Valdosta, GA
  • NPI 1659340768
  NPD (past)
• Melanie Marie Rivers, FNP-C

  • Family Nurse Practitioner
  • Hiawassee, GA
  • NPI 1235994757
  NPD (past)
• Daphne R Charles, PA-C

  • Physician Assistant
  • Belleview, FL
  • NPI 1215995964
  NPD (past)
• Mary Jane Oates, ARNP

  • Nurse Practitioner
  • Ocala, FL
  • NPI 1942207766
  NPD (past)
• David Paul Richardson Jr., PA-C

  • Physician Assistant
  • Medford, OR
  • NPI 1447622345
  NPD (past)

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1265205488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10973 SE 175TH PL STE 100",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344910905",
            "telephone_number": "352-259-6553",
            "fax_number": "352-873-9397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 FANNIN INDUSTRIAL PARK",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305134191",
            "telephone_number": "352-259-6553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN CANCER CENTER OF NORTH GEORGIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "BARBER",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-259-6553",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alvin Ronald Seifert, PHD
• Shaver Medical, PC (DBA: Integrative Sports Medicine of Blue Ridge)
• Lori Whitney Sims, LCSW
• Tanya Marie Singler, MSN, APRN, NP-C
• Margaret-Grace Wright Sisson, PHARMD
• Kimberly Dawn Slatton, APN
• Sleep Services of America
• Patricia Alice Smith, LDO
• Joshua David Snearly, NP
• Southern Drug Company, Inc

• MOHS-Micrographic Surgery Physician in Blue Ridge, GA
• Providers in Blue Ridge, GA by specialty
• MOHS-Micrographic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.