Individual provider Active NPI

Lauren Daugherty

  • Dermatology Physician
  • Newnan, GA
National Provider Identifier
1538690474
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
87387 Issued in GA
Practice address
2045 Highway 34 E
Newnan, GA 30265-1327
Phone
(770) 502-0202
NPI assigned
Mar 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dermatology Physician 207N00000X 87387 GA Primary

Addresses

Primary practice location

2045 Highway 34 E
Newnan, GA 30265-1327

Mailing address

835 Cogburn Ave NW Ste 250
Marietta, GA 30060-1056

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
I20210615003274 GA Practitioner - Dermatology 6800168881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Emory University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aqua Dermatology of Georgia PCGroup PAC ID 6800885757, 56 clinicians

Practice addresses (Care Compare)

2045 Hwy 34 E
Newnan, GA 30265
Phone (770) 502-0202

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision12
Removal of skin lesions1064
Removal or shaving of skin growth66
Skin biopsy267

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatopathology Lab of Skin Cancer Specialists, P.C. CurrentSince Aug 2, 2021 Accepting new patients
Aqua Dermatology of Georgia PC Dermatology CurrentSince Aug 2, 2021 Accepting new patients

Locations

10 Cloverleaf Dr
Cartersville, GA 30120
Phone (770) 386-1261

1150 Brookstone Centre Pkwy
Columbus, GA 31904
Phone (706) 257-4189

850 Charles Hardy Pkwy
Dallas, GA 30157
Phone (770) 336-8888

835 Cogburn Ave NW
Ste 250
Marietta, GA 30060
Phone (770) 422-8815

835 Cogburn Ave NW
Ste 100
Marietta, GA 30060
Phone (770) 422-5557

835 Cogburn Ave NW
Marietta, GA 30060
Phone (770) 422-8815

2045 Highway 34 E
Newnan, GA 30265
Phone (770) 502-0202

18 Riverbend Dr SW
Ste 230SWE
Rome, GA 30161

Organizations & group practices 2

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": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1538690474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 COGBURN AVE NW STE 250",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 HIGHWAY 34 E",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651327",
            "telephone_number": "770-502-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUGHERTY",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-22",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "87387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.