Dermatology and Surgery Specialists of North Atlanta PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY AND SURGERY SPECIALISTS OF NORTH ATLANTA PC

Practice address

4800 Olde Towne Pkwy Ste 250
Marietta, GA 30068-4428

Phone

(770) 971-3376

Fax

(770) 578-8567

NPI assigned

Nov 6, 2020

Last updated

Nov 6, 2020By 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

Onaopemipo OfodileNPI 1104140037

Title

MD

Phone

(770) 971-3376

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 10

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.

• Edward Chen, MD

  • Dermatology Physician
  • Marietta, GA
  • NPI 1982133633
  Medicare reassignment Care Compare group NPD
• Onaopemipo Olayide Ofodile, M.D.

  • Dermatology Physician
  • Marietta, GA
  • NPI 1104140037
  Medicare reassignment NPD Authorized official
• Kathleen Sikora Viscusi, M.D.

  • MOHS-Micrographic Surgery Physician
  • Marietta, GA
  • NPI 1972820975

  Dermatology

  Medicare reassignment Care Compare group NPD
• William Aaron Retterbush, PA-C

  • Physician Assistant
  • Athens, GA
  • NPI 1053934844
  Medicare reassignment Care Compare group
• Candance Kimbrough-Green, M.D.

  • Dermatology Physician
  • Marietta, GA
  • NPI 1366428146
  Medicare reassignment NPD
• Laura Durell, P.A.

  • Physician Assistant
  • Marietta, GA
  • NPI 1689602138
  Medicare reassignment
• Jabreia Fanita James, MD

  • Student in an Organized Health Care Education/Training Program
  • Atlanta, GA
  • NPI 1629728142
  Medicare reassignment
• Lisa M Lewis, PA-C

  • Physician Assistant
  • Marietta, GA
  • NPI 1003857244
  Medicare reassignment
• Chason E. Worthy, PA-C

  • Physician Assistant
  • Marietta, GA
  • NPI 1881734556
  Medicare reassignment
• Anna M Pare', M.D.

  • Dermatology Physician
  • Atlanta, GA
  • NPI 1437135274
  NPD (past)

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604620800000",
    "number": "1447851357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 OLDE TOWNE PKWY STE 250",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684428",
            "telephone_number": "770-971-3376",
            "fax_number": "770-578-8567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 OLDE TOWNE PKWY STE 250",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684428",
            "telephone_number": "770-971-3376",
            "fax_number": "770-578-8567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY AND SURGERY SPECIALISTS OF NORTH ATLANTA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A",
        "authorized_official_last_name": "OFODILE",
        "authorized_official_first_name": "ONAOPEMIPO",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "770-971-3376"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Georgia J Denton, MSPT, MTC
• Whitney S Denton, M.D.
• Denward Healthy Living Inc
• Damon Robert Denzin, PHYSICIAN ASSISTANT
• John Carmen Dercola, PA
• Dermatopathology Lab of Skin Cancer Specialists, P.C.
• Daksha Desai, BPHARM
• Hardi Desai
• Jay Desai
• Sheetal Desai, D.O.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.