NPIMap

Organization Active NPI

Peachtree Dermatology Associates, PC

  • Specialist
  • Atlanta, GA
National Provider Identifier
1316965213
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PEACHTREE DERMATOLOGY ASSOCIATES, PC
Practice address
371 E Paces Ferry Rd NE Ste 900
Atlanta, GA 30305-3291
Phone
(404) 355-1919
Fax
(404) 352-5669
NPI assigned
Jul 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Authorized official

Name
Richard Lowell Sturm, M.D.NPI 1699738955
Title
Owner/Physician
Phone
(404) 355-1919

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

371 E Paces Ferry Rd NE Ste 900
Atlanta, GA 30305-3291

Mailing address

371 E Paces Ferry Rd NE Ste 900
Atlanta, GA 30305-3291
Phone (404) 355-1919

Other names 1

  • Hiram M. Sturm, MD, PA Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040518000580 GA Part B Supplier - Clinic/Group Practice 0143210385 Receives reassigned benefits from 9 practitioners
Practice locations: Atlanta, GA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0705493Peachtree Dermatology Associates371 East Paces Ferry, NE, Suite 900, Atlanta, GA 30305Provider-performed microscopyDec 10, 2027

National Provider Directory

National Provider Directory

Locations

371 E Paces Ferry Rd NE
Ste 900
Atlanta, GA 30305
Phone (404) 355-1919

Practitioners & affiliated clinicians

Practitioners 10

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

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551657600000",
    "number": "1316965213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 E PACES FERRY RD NE STE 900",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303053291",
            "telephone_number": "404-355-1919",
            "fax_number": "404-352-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 E PACES FERRY RD NE STE 900",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303053291",
            "telephone_number": "404-355-1919",
            "fax_number": "404-352-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE DERMATOLOGY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2019-03-04",
        "status": "A",
        "authorized_official_last_name": "STURM",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "LOWELL",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "404-355-1919",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hiram M. Sturm, MD, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Hiram M. Sturm, MD, PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; 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.