Individual provider Active NPI

Skylar Coppinger Ackerman, PA-C

  • Physician Assistant
  • Cartersville, GA
National Provider Identifier
1659132256
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
10 Cloverleaf Dr
Cartersville, GA 30120-2178
Phone
(770) 606-8026
NPI assigned
Jan 22, 2024
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

10 Cloverleaf Dr
Cartersville, GA 30120-2178

Mailing address

10 Cloverleaf Dr
Cartersville, GA 30120-2178
Phone (770) 606-8026

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250424002603 GA Practitioner - Physician Assistant 0345766176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
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)

10 Cloverleaf Dr
Cartersville, GA 30120-2178
Phone (770) 606-8026

835 Cogburn Ave NW
Suite 100
Marietta, GA 30060-1008
Phone (770) 422-5557

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12302GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Aqua Dermatology of Georgia PC CurrentSince Jun 1, 2025 Accepting new patients

Locations

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

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

18 Riverbend Dr SW
Ste 230
Rome, GA 30161
Phone (706) 291-2999

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1705881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1659132256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CLOVERLEAF DR",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202178",
            "telephone_number": "770-606-8026",
            "fax_number": "770-606-8036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CLOVERLEAF DR",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202178",
            "telephone_number": "770-606-8026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "SKYLAR",
        "middle_name": "COPPINGER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-22",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

Sources for this page

Verify at the official NPI Registry.