Northside Dermatology Associates, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

012988 Issued in GA

Legal business name

NORTHSIDE DERMATOLOGY ASSOCIATES, P.C.

Practice address

755 Mount Vernon Hwy
Suite 110
Atlanta, GA 30328-4274

Phone

(404) 256-9692

Fax

(404) 256-9404

NPI assigned

Nov 15, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Stewart E Wiegand, M.D.

Title

Doctor/Owner

Phone

(404) 256-5611

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

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

• Gregory J Cox, MD

  • Dermatology Physician
  • Atlanta, GA
  • NPI 1306803796
  NPD (past)
• Cheryl Lynn Levin, MD

  • Dermatology Physician
  • Newton, MA
  • NPI 1326173154
  NPD (past)

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

{
    "created_epoch": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1508047846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 MOUNT VERNON HWY",
            "address_2": "SUITE 110",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284274",
            "telephone_number": "404-256-9692",
            "fax_number": "404-256-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 MOUNT VERNON HWY",
            "address_2": "SUITE 110",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284274",
            "telephone_number": "404-256-9692",
            "fax_number": "404-256-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE DERMATOLOGY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "WIEGAND",
        "authorized_official_first_name": "STEWART",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "404-256-5611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "012988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00176481C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CM5399",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northside Cardiology-Electrophysiology, LLC
• Northside Cardiology, PC
• Northside Cardiovascular Institute LLC
• Northside Cherokee Urgent Care, LLC
• Northside Cosmetic and Dental Implant Center, PC
• Northside Gastroenterology
• Northside Home Care LLC
• Northside Hospital Homecare Pharmacy
• Northside Hospital Pharmacy at Meridian Mark
• Northside Hospital, Inc.

• All providers in Atlanta, GA
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; 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.