North Atlanta Dermatology

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

2004000225 Issued in GA

Legal business name

NORTH ATLANTA DERMATOLOGY

Practice address

3850 Pleasant Hill Rd
Duluth, GA 30096-4807

Phone

(770) 814-8222

NPI assigned

Aug 22, 2005

Last updated

Jul 3, 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

Laura J Hernandez

Title

Credentialing Specialist

Phone

(813) 493-5252

Specialties & licenses 1

Addresses

Other identifiers 5

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 18

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.

• Jaclyn Berry Adair, NP

  • Nurse Practitioner
  • Suwanee, GA
  • NPI 1447079082
  Medicare reassignment Care Compare group NPD
• Brandon William Burroway, MD

  • MOHS-Micrographic Surgery Physician
  • Duluth, GA
  • NPI 1023646064

  Dermatology

  Medicare reassignment Care Compare group NPD
• Abhik Damian Dhar, MD

  • Dermatology Physician
  • Cumming, GA
  • NPI 1306890678
  Medicare reassignment Care Compare group NPD
• Aimen Ismail, MD

  • Dermatology Physician
  • Buford, GA
  • NPI 1790196798
  Medicare reassignment Care Compare group NPD
• Hasan Khosravi, MD

  • Dermatology Physician
  • Peachtree Corners, GA
  • NPI 1649790627
  Medicare reassignment Care Compare group NPD
• Rachel ABA Orleans, MD, MPH

  • Dermatology Physician
  • Duluth, GA
  • NPI 1316500622
  Medicare reassignment Care Compare group NPD
• Gabrielle Marie Sabini, M.D.

  • Dermatology Physician
  • Duluth, GA
  • NPI 1134111495
  Medicare reassignment Care Compare group NPD
• Sara Barr, PA

  • Medical Physician Assistant
  • Duluth, GA
  • NPI 1801930862
  Medicare reassignment Care Compare group
• Valery Dinh, PA-C

  • Physician Assistant
  • Cumming, GA
  • NPI 1023795531
  Medicare reassignment Care Compare group
• Charles Jacob Douchy, M.D.

  • Dermatology Physician
  • Duluth, GA
  • NPI 1003808361
  Medicare reassignment Care Compare group
• Holly Musgrove Guttshall, PA-C

  • Physician Assistant
  • Duluth, GA
  • NPI 1437697893
  Medicare reassignment Care Compare group
• Nikki Orciuch Traylor, PA-C

  • Physician Assistant
  • Duluth, GA
  • NPI 1982981155
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688342400000",
    "number": "1427040799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 PLEASANT HILL RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964807",
            "telephone_number": "770-814-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 PLEASANT HILL RD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964807",
            "telephone_number": "770-814-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH ATLANTA DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-22",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "813-493-5252"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "2004000225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300033599B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55003258A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA #",
            "identifier": "11D0973833",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300033599A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA ADDL LOCATION",
            "identifier": "11D1050070",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Marie Noonan, PH.D.
• Halliday Johnson Norman
• Kenya Norris
• Lakrista Dannielle Norris
• North Atlanta Chiropractic Center
• North Atlanta Kids Dentistry, LLC
• North Atlanta Orthopaedic Surgery Center
• North Atlanta Pdoiatry GRP, PC (Foot and Ankle Centers of NE Ga)
• North Georgia Oral and Facial Surgery LLC
• North of Atlanta Pain Clinic, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.