Southwest Georgia Dermatology, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

035424 Issued in GA

Legal business name

SOUTHWEST GEORGIA DERMATOLOGY, P.C.

Practice address

2401 Osler CT
Albany, GA 31707-0205

Phone

(229) 889-1827

Fax

(229) 889-0305

NPI assigned

May 23, 2007

Last updated

Aug 22, 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

Stuart M. Goldsmith, M.D.NPI 1336201813

Title

President

Phone

(229) 889-1827

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 1

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.

• Stuart Martin Goldsmith, M.D.

  • Dermatology Physician
  • Albany, GA
  • NPI 1336201813
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508076969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 OSLER CT",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317070205",
            "telephone_number": "229-889-1827",
            "fax_number": "229-889-0305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 OSLER CT",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317070205",
            "telephone_number": "229-889-1827",
            "fax_number": "229-889-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST GEORGIA DERMATOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOLDSMITH",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-889-1827",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "035424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Albany, GA
• Providers in Albany, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.