Kenneth Jeremy Micheff, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

007281 Issued in GA

Practice address

1107 Memorial Dr
Suite 201
Dalton, GA 30720-8668

Phone

(706) 277-7311

Fax

(706) 272-3512

NPI assigned

Dec 4, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jeremy Micheff Other name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in GA, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Skin Cancer and Cosmetic Dermatology Center PCGroup PAC ID 3375591209, 24 clinicians

Skin Cancer and Cosmetic Dermatology Center PCGroup PAC ID 8224118773, 29 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

79.32 of 100Reported as group

Quality

64.03

Promoting interoperability

97

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: jeremy.micheff@sccdc.gadirect.net

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.

• Skin Cancer & Cosmetic Dermatology Center, PC

  • Dermatology Physician
  • Dalton, GA
  • NPI 1376605394
  Medicare reassignment Care Compare group
• Skin Cancer and Cosmetic Dermatology Center PC

  • Dermatology Physician
  • Chattanooga, TN
  • NPI 1144419458
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1417651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1649677709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 MEMORIAL DR",
            "address_2": "SUITE 201",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307208668",
            "telephone_number": "706-277-7311",
            "fax_number": "706-272-3512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 MEMORIAL DR",
            "address_2": "SUITE 201",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307208668",
            "telephone_number": "706-277-7311",
            "fax_number": "706-272-3512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHEFF",
        "first_name": "KENNETH",
        "middle_name": "JEREMY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-12-04",
        "last_updated": "2023-11-27",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "007281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jychung@directaddress.net",
            "affiliation": "Y",
            "affiliationName": "Skin Cancer & Cosmetic Dermatology Center, PC",
            "address_1": "1107 Memorial Dr",
            "address_2": "Suite 201",
            "city": "Dalton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "307208668",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jychung@directaddress.net",
            "affiliation": "Y",
            "affiliationName": "Skin Cancer and Cosmetic Dermatology Center PC",
            "address_1": "2253 Chambliss Ave NW",
            "address_2": "Suite 202",
            "city": "Cleveland",
            "state": "TN",
            "country_code": "US",
            "postal_code": "373113861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JEREMY",
            "last_name": "MICHEFF",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Roy Mendizabal
• Haley Mertz, PA
• Wimberly Meszaros
• Cynthia L Michaels, MA, OTR L
• James Neal Micheff, MSN, FNP-C
• Natasha Micheff, NP-C
• Robby John Mickelson, PTA
• Connie Dianne Middleton, NP-C
• Merle E Milburn Jr., M.D.
• Ashley Brooks Milford, OTD, OTR/L

• Physician Assistant in Dalton, GA
• Providers in Dalton, GA by specialty
• Physician Assistant in Georgia

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