Individual provider Active NPI

Sumayah Jamila Taliaferro, MD

  • Dermatology Physician
  • Atlanta, GA
National Provider Identifier
1467658393
Registry record updated Jul 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
059337 Issued in GA
Practice address
3131 Maple Dr NE
Suite 102
Atlanta, GA 30305-2515
Phone
(404) 816-7900
Fax
(404) 816-7929
NPI assigned
Jun 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 059337 GA
Dermatology Physician 207N00000X 059337 GA Primary

Addresses

Primary practice location

3131 Maple Dr NE
Suite 102
Atlanta, GA 30305-2515

Mailing address

PO Box 52226
Atlanta, GA 30355-0226
Phone (404) 816-7900

Other identifiers 1

IdentifierTypeStateIssuer
059337OtherSTATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080610000700 GA Practitioner - Dermatology 0547330029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

232 19TH St NW
Suite 7230
Atlanta, GA 30363-1131

2950 Stone Hogan Connector Rd SW
BLDG 4
Atlanta, GA 30331-2837
Phone (404) 349-7440

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions78
Removal or shaving of skin growth1-10
Skin biopsy105

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
059337GAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Dermatology & Aesthetics PC Dermatology CurrentSince Apr 1, 2015 Accepting new patients
Wesley S Wilborn MD PC Dermatology Past Accepting new patients
Atlanta Center of Dermatology and Medispa PC Dermatology PastSince Jan 1, 2005 Accepting new patients

Locations

232 19th St NW
#7230
Atlanta, GA 30363
Phone (404) 873-1795

2950 Stone Hogan Rd
Bldg A
Atlanta, GA 30331
Phone (404) 781-2800

2950 Stone Hogan Connector Rd SW
Bldg 4
Atlanta, GA 30331
Phone (404) 349-7440

232 19th St NW
Ste 7230
Atlanta, GA 30363
Phone (404) 873-1795

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.

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309478400000",
    "number": "1467658393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52226",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303550226",
            "telephone_number": "404-816-7900",
            "fax_number": "404-816-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 MAPLE DR NE",
            "address_2": "SUITE 102",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052515",
            "telephone_number": "404-816-7900",
            "fax_number": "404-816-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALIAFERRO",
        "first_name": "SUMAYAH",
        "middle_name": "JAMILA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2011-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "059337",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "059337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "059337",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.