Organization Active NPI

Sage Dermatology, LLC

  • Dermatology Physician
  • Buford, GA
National Provider Identifier
1467290924
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SAGE DERMATOLOGY, LLC
Practice address
4986 Cooper Farm Dr
Buford, GA 30518-3277
Phone
(626) 404-8836
NPI assigned
Jul 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

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

Authorized official

Name
Dr. Joshua Andrew Chang, MDNPI 1205399680
Title
Founder
Phone
(626) 404-8836

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

4986 Cooper Farm Dr
Buford, GA 30518-3277

Mailing address

4986 Cooper Farm Dr
Buford, GA 30518-3277
Phone (626) 404-8836

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721260800000",
    "number": "1467290924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4986 COOPER FARM DR",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305183277",
            "telephone_number": "626-404-8836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4986 COOPER FARM DR",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305183277",
            "telephone_number": "626-404-8836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "626-404-8836",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buford, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.