NPIMap

Organization Active NPI

Forefront Dermatology, S.C.

  • Dermatology Physician
  • Atlanta, GA
National Provider Identifier
1710449079
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
FOREFRONT DERMATOLOGY, S.C.
Practice address
5505 Peachtree Dunwoody Rd Ste 412
Atlanta, GA 30342-1758
Phone
(404) 459-9177
Fax
(404) 389-0400
NPI assigned
Apr 4, 2019
Last updated
Nov 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Authorized official

Name
Dr. Betsy J Wernli, MDNPI 1437378973
Title
President
Phone
(920) 482-0671

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary
MOHS-Micrographic Surgery Physician 207ND0101X NU
Procedural Dermatology Physician 207NS0135X NU

Addresses

Primary practice location

5505 Peachtree Dunwoody Rd Ste 412
Atlanta, GA 30342-1758

Mailing address

801 York St
Manitowoc, WI 54220-4630
Phone (920) 663-9008

Other practice location 1

2710 Old Milton Pkwy Ste 100
Alpharetta, GA 30009-2478
Phone (470) 408-3668

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190611003824 GA Part B Supplier - Clinic/Group Practice 3779471701 Receives reassigned benefits from 16 practitioners
4 other NPIs on this enrollment
Practice locations: Brunswick, GA; Waycross, GA; Suwanee, GA; St Simons Island, GA; Cumming, GA; Alpharetta, GA; Atlanta, GA; Saint Marys, GA

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
11D0679766Forefront Dermatology, SC5505 Peachtree Dunwoody Road, Atlanta, GA 30342ComplianceMar 20, 2028
11D2288600Forefront Dermatology, SC2710 Old Milton Pkwy, Ste 100, Alpharetta, GA 30009Provider-performed microscopyAug 28, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1710449079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 PEACHTREE DUNWOODY RD STE 412",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421758",
            "telephone_number": "404-459-9177",
            "fax_number": "404-389-0400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2710 Old Milton Pkwy Ste 100",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300092478",
            "country_code": "US",
            "telephone_number": "470-408-3668",
            "fax_number": "470-589-2660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FOREFRONT DERMATOLOGY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-04",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "WERNLI",
        "authorized_official_first_name": "BETSY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-482-0671",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.