Organization Active NPI

Cahaba Dermatology & Skin Health Center, LLC

  • Dermatopathology Physician
  • Hoover, AL
National Provider Identifier
1619213204
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
28104 Issued in AL
Legal business name
CAHABA DERMATOLOGY & SKIN HEALTH CENTER, LLC
Practice address
2279 Valleydale Rd Ste 100
Hoover, AL 35244-2111
Phone
(205) 214-7546
NPI assigned
Dec 31, 2012
Last updated
Feb 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Authorized official

Name
Dr. Vlada Groysman, M. D.NPI 1255545455
Title
Physician
Phone
(205) 214-7546

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
Dermatopathology Physician 207ND0900X 28104 AL Primary

Addresses

Primary practice location

2279 Valleydale Rd Ste 100
Hoover, AL 35244-2111

Mailing address

2279 Valleydale Rd Ste 100
Hoover, AL 35244-2111
Phone (205) 214-7546

Other practice location 1

1649 McFarland Blvd N
Tuscaloosa, AL 35406-2281
Phone (205) 214-7546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130206000233 AL Part B Supplier - Clinic/Group Practice 5193979839 Receives reassigned benefits from 7 practitioners
Practice locations: Hoover, AL; Vestavia, AL; Tuscaloosa, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2057090Cahaba Dermatology & Skin Health Center LLC2279 Valleydale Road Suite 100, Hoover, AL 35244Certificate of waiverApr 15, 2027
01D2141359Cahaba Dermatology & Skin Health1649 North McFarland Blvd, Suite 201, Tuscaloosa, AL 35406Provider-performed microscopyOct 7, 2027

National Provider Directory

National Provider Directory

Locations

2279 Valleydale Rd
Ste 100
Hoover, AL 35244
Phone (205) 214-7546

2290 Valleydale Rd
Ste 204
Hoover, AL 35244
Phone (205) 214-7546

1649 McFarland Blvd N
Tuscaloosa, AL 35406
Phone (205) 214-7546

3965 Crosshaven Dr
Ste 113
Vestavia, AL 35243
Phone (205) 214-7546

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1356912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677456000000",
    "number": "1619213204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2279 VALLEYDALE RD STE 100",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352442111",
            "telephone_number": "205-214-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2279 VALLEYDALE RD STE 100",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352442111",
            "telephone_number": "205-214-7546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1649 McFarland Blvd N",
            "address_purpose": "LOCATION",
            "city": "Tuscaloosa",
            "state": "AL",
            "postal_code": "354062281",
            "country_code": "US",
            "telephone_number": "205-214-7546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAHABA DERMATOLOGY & SKIN HEALTH CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-31",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A",
        "authorized_official_last_name": "GROYSMAN",
        "authorized_official_first_name": "VLADA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "205-214-7546",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "AL",
            "license": "28104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoover, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.