Organization Active NPI

Skin Care Physicians of Georgia, P.C.

  • Dermatology Physician
  • Macon, GA
National Provider Identifier
1346351582
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SKIN CARE PHYSICIANS OF GEORGIA, P.C.
Practice address
308 Coliseum Dr Ste 200
Macon, GA 31217-3861
Phone
(478) 742-2180
Fax
(478) 745-2623
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Authorized official

Name
Davud B Kent, M.D.
Title
Owner, Sr Physician, Ceo
Phone
(478) 742-2180

Specialties & licenses 1

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

Addresses

Primary practice location

308 Coliseum Dr Ste 200
Macon, GA 31217-3861

Mailing address

308 Coliseum Dr Ste 200
Macon, GA 31217-3861
Phone (478) 742-2180

Other names 1

  • Dermatologic Surgery Specialists, P.C. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040203000364 GA Part B Supplier - Clinic/Group Practice 7517850712 Receives reassigned benefits from 20 practitioners
Practice locations: Tifton, GA; Warner Robins, GA; Milledgeville, GA; Macon, GA; Locust Grove, GA; Greensboro, GA; Gray, GA; Forsyth, 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
11D0697595Skin Care Physicians of Georgia308 Coliseum Drive, Suite 200, Macon, GA 31217ComplianceAug 16, 2026

National Provider Directory

National Provider Directory

Locations

906 N 5th St
Ste D45
Cordele, GA 31015
Phone (912) 276-0972

102 N Lee St
Forsyth, GA 31029

110 Stone Brooke Dr
Gray, GA 31032
Phone (478) 621-2100

1210 Commerce Dr
Ste 113114
Greensboro, GA 30642
Phone (478) 742-2180

1210 Commerce Dr
Ste 113114CE
Greensboro, GA 30642

1210 Commerce Dr
Ste 114
Greensboro, GA 30642

1210 Commerce Dr
Ste 113
Greensboro, GA 30642

678 S 8TH St
Griffin, GA 30224
Phone (229) 271-4652

330 Hospital Dr
Bldg C
Macon, GA 31217
Phone (478) 742-2180

308 Coliseum Dr
Ste 200
Macon, GA 31217
Phone (478) 314-0784

840 W Thomas St
Milledgeville, GA 31061
Phone (478) 453-2700

804 W Thomas St
Milledgeville, GA 31061

907 18th St E
Ste 310
Tifton, GA 31794

116 Tommy Stalnaker Dr
Ste 3A
Warner Robins, GA 31088

116 Tommy Stalnaker Dr
Ste 3
Warner Robins, GA 31088

Practitioners & affiliated clinicians

Practitioners 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533168000000",
    "number": "1346351582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 COLISEUM DR STE 200",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173861",
            "telephone_number": "478-742-2180",
            "fax_number": "478-745-2623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 COLISEUM DR STE 200",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173861",
            "telephone_number": "478-742-2180",
            "fax_number": "478-745-2623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN CARE PHYSICIANS OF GEORGIA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2018-08-02",
        "status": "A",
        "authorized_official_last_name": "KENT",
        "authorized_official_first_name": "DAVUD",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER, SR PHYSICIAN, CEO",
        "authorized_official_telephone_number": "478-742-2180",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatologic Surgery Specialists, P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.