Atlanta Center for Dermatologic Diseases PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

032990 Issued in GA

Legal business name

ATLANTA CENTER FOR DERMATOLOGIC DISEASES PC

Practice address

1265 Upper Hembree Rd
Ste 100
Roswell, GA 30076-1143

Phone

(770) 751-1433

Fax

(770) 751-7410

NPI assigned

Apr 10, 2006

Last updated

Dec 17, 2012By 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

Ms. Anita Reiner

Title

Bookkeeping Insurance

Phone

(770) 751-1433

Specialties & licenses 5

Addresses

Other identifiers 14

Other names 1

• Drs D Levine J Silyerstein M Fisher M Weil K Ellner Other name

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 14

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.

• Kevin S Berman, M.D, , PH.D.

  • Dermatology Physician
  • Roswell, GA
  • NPI 1336118983
  Medicare reassignment Care Compare group NPD
• Tamu Tayari Brown, M.D.

  • Dermatology Physician
  • Roswell, GA
  • NPI 1609009174
  Medicare reassignment Care Compare group NPD
• Sridhar Dronavalli

  • Dermatology Physician
  • Sandy Springs, GA
  • NPI 1538326772
  Medicare reassignment Care Compare group NPD
• David Jonathan Levine, M.D.

  • Dermatology Physician
  • Roswell, GA
  • NPI 1881693877
  Medicare reassignment Care Compare group NPD
• Shaanan Satish Shetty, MD

  • Dermatology Physician
  • Roswell, GA
  • NPI 1346503810
  Medicare reassignment Care Compare group NPD
• Martin Layne Weil, M.D.

  • Dermatology Physician
  • Roswell, GA
  • NPI 1639178643
  Medicare reassignment Care Compare group NPD
• Taryn Marie Degrazia West, MD

  • Dermatology Physician
  • Atlanta, GA
  • NPI 1124655238
  Medicare reassignment Care Compare group NPD
• Kenneth Mark Ellner, M.D.

  • Dermatology Physician
  • Roswell, GA
  • NPI 1447259577
  Medicare reassignment Care Compare group
• Judith Lila Silverstein, M.D.

  • Dermatology Physician
  • Roswell, GA
  • NPI 1033118146
  Medicare reassignment NPD
• Felicia Loren Hoffman, PA-C

  • Medical Physician Assistant
  • Roswell, GA
  • NPI 1386824233
  Medicare reassignment
• Jenny Dickson Laminack, PA-C

  • Adult Health Clinical Nurse Specialist
  • Cumming, GA
  • NPI 1023488939
  Medicare reassignment
• Rebecca I Myles, PA

  • Physician Assistant
  • Atlanta, GA
  • NPI 1801269394
  Medicare reassignment

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355702400000",
    "number": "1417910431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 UPPER HEMBREE RD",
            "address_2": "STE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761143",
            "telephone_number": "770-751-1433",
            "fax_number": "770-751-7410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 UPPER HEMBREE RD",
            "address_2": "STE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761143",
            "telephone_number": "770-751-1433",
            "fax_number": "770-751-7410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA CENTER FOR DERMATOLOGIC DISEASES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2012-12-17",
        "status": "A",
        "authorized_official_last_name": "REINER",
        "authorized_official_first_name": "ANITA",
        "authorized_official_title_or_position": "BOOKKEEPING INSURANCE",
        "authorized_official_telephone_number": "770-751-1433",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "027080",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "032990",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "034135",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "044141",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "032377",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO GEORGIA NETWORK",
            "identifier": "1751",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO HEALTH FIRST",
            "identifier": "0306784",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "070004931",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO PARTNERS",
            "identifier": "104004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY PLUS",
            "identifier": "045942",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS BLUE CROSS",
            "identifier": "237691",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTH CARE",
            "identifier": "472244",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "077541037",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF GEORGIA",
            "identifier": "237691",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CM0095",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRUCARE PLUS",
            "identifier": "D45942",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRUCARE SELECT",
            "identifier": "D45942",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRUDENTIAL HMD AFFILIAT",
            "identifier": "D45942",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMORY CARE",
            "identifier": "D45942",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drs D Levine J Silyerstein M Fisher M Weil K Ellner",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kimberlyn R Atherton Jenkins, DDS
• Cherie Atkins, DDS
• Tammara Atkinson, FNP
• Atlanta Arthritis Center, P.C.
• Atlanta Body Care, LLC
• Atlanta Counseling & Evaluation Services, LLC
• Atlanta Counseling Solutions, LLC
• Atlanta Healthcare, LLC
• Atlanta North Gynecology, P.C.
• Atlanta Psychiatric Medicine, Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.