Dione Marcus Super, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

60121 Issued in GA

Practice address

1364 Wellbrook Cir NE
Conyers, GA 30012-3872

Phone

(770) 285-3533

Fax

(770) 761-7179

NPI assigned

May 22, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Dermatology

Education

Medical College of Georgia School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: superdermatologydionesuper@138618.advancedmd-direct.com

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.

• Super Dermatology LLC

  • Dermatology Physician
  • Conyers, GA
  • NPI 1669971776
  Medicare reassignment NPD Authorized official
• Dermatology Consultants, P.C.

  • Dermatology Physician
  • Atlanta, GA
  • NPI 1851421531
  Medicare reassignment NPD
• Wesley S Wilborn MD PC

  • Dermatology Physician
  • Atlanta, GA
  • NPI 1750554978
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1598974503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1364 WELLBROOK CIR NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123872",
            "telephone_number": "770-285-3533",
            "fax_number": "770-761-7179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 WELLBROOK CIR NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123872",
            "telephone_number": "770-285-3533",
            "fax_number": "770-761-7179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4151 Hospital Dr NE",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "GA",
            "postal_code": "300142565",
            "country_code": "US",
            "telephone_number": "770-784-0343",
            "fax_number": "678-729-9769",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4151 Hospital Dr NE",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "GA",
            "postal_code": "300142565",
            "country_code": "US",
            "telephone_number": "770-784-0343",
            "fax_number": "678-729-9769",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1364 Wellbrook Cir NE",
            "address_purpose": "LOCATION",
            "city": "Conyers",
            "state": "GA",
            "postal_code": "300123872",
            "country_code": "US",
            "telephone_number": "770-285-3533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1364 Wellbrook Cir NE",
            "address_purpose": "LOCATION",
            "city": "Conyers",
            "state": "GA",
            "postal_code": "300123872",
            "country_code": "US",
            "telephone_number": "770-285-3533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUPER",
        "first_name": "DIONE",
        "middle_name": "MARCUS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MI",
            "license": "4301083750",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "60121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michaela Monique Summers, ED.S., LPC
• Buddy Sumner, MHC
• Sunday Legacy Home Care Services, LLC.
• Sunrise Health Services
• Super Dermatology LLC
• Surgical Assoicates of Metro Atlanta, LLC
• Surgical Medical Associates
• Stephen John Suss, MD
• Elizabeth Ann Sutton
• Makayla Swann, RBT

• Dermatology Physician in Conyers, GA
• Providers in Conyers, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.