NPIMap

Organization Active NPI

Brookwood Dermatology, PC

  • MOHS-Micrographic Surgery Physician
  • Birmingham, AL
National Provider Identifier
1487663266
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
Legal business name
BROOKWOOD DERMATOLOGY, PC
Practice address
521 Montgomery Hwy
Suite 117
Birmingham, AL 35216-1878
Phone
(205) 824-4441
Fax
(205) 822-3978
NPI assigned
Aug 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Authorized official

Name
Donald W Walters
Title
Owner
Phone
(205) 824-4441

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X Primary
Procedural Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207NS0135X

Addresses

Primary practice location

521 Montgomery Hwy
Suite 117
Birmingham, AL 35216-1878

Mailing address

521 Montgomery Hwy
Suite 117
Birmingham, AL 35216-1878
Phone (205) 824-4441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040311000242 AL Part B Supplier - Clinic/Group Practice 4284523069 Receives reassigned benefits from 4 practitioners
Practice locations: Vestavia Hills, AL; Pell City, AL; Gardendale, AL

National Provider Directory

National Provider Directory

Locations

521 Montgomery Hwy
Ste 117
Vestavia Hills, AL 35216
Phone (205) 824-4441

521 Montgomery Hwy
Vestavia Hills, AL 35216

Practitioners & affiliated clinicians

Practitioners 7

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": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750723200000",
    "number": "1487663266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 MONTGOMERY HWY",
            "address_2": "SUITE 117",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352161878",
            "telephone_number": "205-824-4441",
            "fax_number": "205-822-3978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 MONTGOMERY HWY",
            "address_2": "SUITE 117",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352161878",
            "telephone_number": "205-824-4441",
            "fax_number": "205-822-3978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKWOOD DERMATOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-824-4441"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.