NPIMap

Individual provider Active NPI

Leah Anne Cardwell, M.D.

  • Dermatology Physician
  • Detroit, MI
National Provider Identifier
1447646419
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
91058 Issued in GA
Practice address
18652 Fairway Dr
Detroit, MI 48221-2279
Phone
(313) 790-5469
NPI assigned
Apr 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 91058 GA Primary

Addresses

Primary practice location

18652 Fairway Dr
Detroit, MI 48221-2279

Mailing address

18652 Fairway Dr
Detroit, MI 48221-2279

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL, SD3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20220421001894 GA Practitioner - Dermatology 5799115333 Reassigns benefits to 1 organization
I20250924004675 AL Practitioner - DermatologyPractitioner - Pathology 5799115333 Reassigns benefits to 1 organization
I20260325003763 SD Practitioner - Dermatology 5799115333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Pathology
Education
Howard University College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Dermatology of Alabama, Inc.Group PAC ID 2466866355, 9 clinicians
Epiphany Dermatology of Georgia, LLCGroup PAC ID 6800798182, 22 clinicians

Practice addresses (Care Compare)

286 Mitylene Park Dr
Montgomery, AL 36117-3548
Phone (334) 396-1555

4150 5TH St
Rapid City, SD 57701-6022
Phone (605) 755-4100

874 Lanier Ave W
Suite 270
Fayetteville, GA 30214-7617
Phone (770) 251-5111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.74 of 100Reported as group
Quality
83.29
Promoting interoperability
100
Improvement activities
40
Cost
79.17

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions101
Skin biopsy72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Epiphany Dermatology of Georgia, LLC Dermatology CurrentSince May 1, 2022 Accepting new patients
Advanced Dermatology of Alabama, Inc. Dermatology CurrentSince Sep 1, 2025 Accepting new patients

Locations

286 Mitylene Park Dr
Montgomery, AL 36117
Phone (334) 396-1555

151 Southhall Ln
Ste 300
Maitland, FL 32751
Phone (407) 917-7293

874 Lanier Ave W
Ste 270
Fayetteville, GA 30214
Phone (770) 461-1335

710 Newnan Crossing Byp
#100
Newnan, GA 30263

1975 Highway 54 W
Ste 250
Peachtree City, GA 30269

6601 Vaught Ranch Rd
Ste 200
Austin, TX 78730
Phone (575) 640-6306

7300 Ranch Road 2222
Ste 200
Austin, TX 78730

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1428364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1447646419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18652 FAIRWAY DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18652 FAIRWAY DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212279",
            "telephone_number": "313-790-5469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDWELL",
        "first_name": "LEAH",
        "middle_name": "ANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-07",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "91058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.