Lanier Dermatology & Skin Cancer Specialists, PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

LANIER DERMATOLOGY & SKIN CANCER SPECIALISTS, PC

Practice address

605 S Enota Dr NE
Gainesville, GA 30501-2437

Phone

(770) 538-0208

Fax

(770) 538-0556

NPI assigned

May 10, 2006

Last updated

Dec 11, 2015By 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

Mrs. Carmen L Smith

Title

Manager

Phone

(770) 538-0208

Specialties & licenses 1

Addresses

Other identifiers 9

Other names 1

• Kevin L. Smith, MD PC Former legal business name

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 8

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.

• Michael B Reynolds, MD

  • Dermatology Physician
  • Gainesville, GA
  • NPI 1487604021
  Medicare reassignment Care Compare group NPD
• Kevin L Smith, MD

  • Dermatology Physician
  • Gainesville, GA
  • NPI 1306896931
  Medicare reassignment Care Compare group NPD
• Erica Golden Watson, NP-C

  • Family Nurse Practitioner
  • Gainesville, GA
  • NPI 1184347429
  Medicare reassignment Care Compare group NPD
• Davina Sara Braselton, PA-C

  • Physician Assistant
  • Gainesville, GA
  • NPI 1659329514
  Medicare reassignment Care Compare group
• Gloria Jamiellen Wood, PA-C

  • Physician Assistant
  • Watkinsville, GA
  • NPI 1184302663
  Medicare reassignment Care Compare group
• Jean Marie Laramore Ellis, PA-C

  • Physician Assistant
  • Statesville, NC
  • NPI 1356362404

  GA

  Medicare reassignment Care Compare group
• Reagan Brooke Morgan, PA-C

  • Dermatology Physician
  • Marietta, GA
  • NPI 1295413805
  Medicare reassignment
• Justin R Smith, PA-C

  • Medical Physician Assistant
  • Gainesville, GA
  • NPI 1376879825
  Medicare reassignment

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449792000000",
    "number": "1437109899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 S ENOTA DR NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012437",
            "telephone_number": "770-538-0208",
            "fax_number": "770-538-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S ENOTA DR NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012437",
            "telephone_number": "770-538-0208",
            "fax_number": "770-538-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANIER DERMATOLOGY & SKIN CANCER SPECIALISTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2015-12-11",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "770-538-0208",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007735230",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000678983B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005756529",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1487604021",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "070015990",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1306896931",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH9982",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000814767A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "070011202",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kevin L. Smith, MD PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Hamilton Vo Lam, M.D., MPH
• Linh My Lam
• David A Langford, MD
• Robert R Langford, PA
• Lanier Dental Group Inc
• Lanier Eye Associates, LLC (Advanced Eye Center)
• Lanier Eye Associates, LLC (Advanced Eye Surgery and Laser Center)
• Lanier Eye Associates, LLC (Advanced Eye Center)
• Lanier Foot and Ankle LLC
• Lanier Health Link

• Dermatology Physician in Gainesville, GA
• Providers in Gainesville, 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 11, 2015; 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.