Babcock Dermatology PC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

59368 Issued in GA

Legal business name

BABCOCK DERMATOLOGY PC

Practice address

4890 Roswell Rd NE
Suite B-10
Atlanta, GA 30342-2606

Phone

(216) 647-1370

NPI assigned

Dec 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Melissa BabcockNPI 1700800752

Title

President

Phone

(678) 927-9027

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Melissa Babcock, MD

  • MOHS-Micrographic Surgery Physician
  • Atlanta, GA
  • NPI 1700800752
  Medicare reassignment Care Compare group NPD Authorized official
• Katelyn Ann Ely, PA-C

  • Physician Assistant
  • Atlanta, GA
  • NPI 1770136574
  Medicare reassignment Care Compare group
• Amanda Leigh Goldner, PA-C

  • Physician Assistant
  • Atlanta, GA
  • NPI 1467439851
  Medicare reassignment Care Compare group
• Katherine Mary Siedor, PA

  • Medical Physician Assistant
  • Lawrenceville, GA
  • NPI 1285013458
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1198108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1750565180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4627 DALMER RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303422725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4890 ROSWELL RD NE",
            "address_2": "SUITE B-10",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303422606",
            "telephone_number": "216-647-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BABCOCK DERMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-20",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "BABCOCK",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-927-9027",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "GA",
            "license": "59368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie A Babalola-Erinle, RPH
• Adeniyi Caxton Babalola, MD
• Aminat Aina Babalola, NP
• Alexandr Babayeuski, MD
• Jennifer Babbie, RD, LD, CDCES
• Melissa Babcock, MD
• Selena Babcock, DC
• Virginia Lee Babcock
• Katherine Baber
• Adam Conley Babineaux

• Medical Specialty Clinic/Center in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Medical Specialty Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; 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.