Chatham Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

034016 Issued in GA

Legal business name

CHATHAM DERMATOLOGY LLC

Practice address

820 E 67TH St
Savannah, GA 31405-4611

Phone

(912) 355-9818

Fax

(912) 356-9878

NPI assigned

Mar 13, 2014

Last updated

Mar 13, 2014By 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

Dr. Tonya L McCullough, MDNPI 1417064171

Title

Owner

Phone

(912) 355-9818

Specialties & licenses 1

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 1

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.

• Tonya Lewis McCullough, M.D.

  • Specialist
  • Savannah, GA
  • NPI 1417064171
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1394668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394668800000",
    "number": "1407272511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 E 67TH ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054611",
            "telephone_number": "912-355-9818",
            "fax_number": "912-356-9878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E 67TH ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314054611",
            "telephone_number": "912-355-9818",
            "fax_number": "912-356-9878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHATHAM DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-13",
        "last_updated": "2014-03-13",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "TONYA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-355-9818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "034016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chatham County Board of Health (Chatham County Health Department-Midtown)
• Chatham County Board of Health
• Chatham County Board of Health (Community Care Services Program)
• Chatham County Health Department
• Chatham County Health Dept
• Chatham Eye Associates
• Chatham Hospitalists
• Chatham Hospitalists
• Chatham Hospitalists -- SJ, LLC
• Chatham Hosptialists, LLC

• Dermatology Physician in Savannah, GA
• Providers in Savannah, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.