Organization Active NPI

Buckhead Dermatology

  • Dermatology Physician
  • Atlanta, GA
National Provider Identifier
1538359617
Registry record updated Jul 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
033207 Issued in GA
Legal business name
BUCKHEAD DERMATOLOGY
Practice address
2961 Hardman CT NE
Atlanta, GA 30305-3424
Phone
(404) 816-4000
Fax
(404) 816-4020
NPI assigned
Jul 26, 2007
Last updated
Jul 26, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2007

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

Authorized official

Name
Dr. Sherrie-Ann V Straughn, M.D.NPI 1477569085
Title
President
Phone
(404) 816-4000

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 Physician 207N00000X 033207 GA Primary

Addresses

Primary practice location

2961 Hardman CT NE
Atlanta, GA 30305-3424

Mailing address

PO Box 53136
Atlanta, GA 30355-1136
Phone (404) 816-4000

Other identifiers 1

IdentifierTypeStateIssuer
00516656BMedicaidGA

National Provider Directory

National Provider Directory

Locations

2961 Hardman Ct NE
Atlanta, GA 30305
Phone (404) 816-4000

1720 Phoenix Blvd
College Park, GA 30349
Phone (770) 909-8007

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185408000000",
    "number": "1538359617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53136",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303551136",
            "telephone_number": "404-816-4000",
            "fax_number": "404-816-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2961 HARDMAN CT NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303053424",
            "telephone_number": "404-816-4000",
            "fax_number": "404-816-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKHEAD DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2007-07-26",
        "status": "A",
        "authorized_official_last_name": "STRAUGHN",
        "authorized_official_first_name": "SHERRIE-ANN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-816-4000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "033207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00516656B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.