Decatur Dermatology, PC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DECATUR DERMATOLOGY, PC

Practice address

620 Walnut Street NE
Suite a
Decatur, AL 35601-2456

Phone

(256) 353-7775

Fax

(256) 353-7765

NPI assigned

Jul 17, 2007

Organization subpart

No

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

Authorized official

Name

Samantha Wyatt, MDNPI 1942247150

Title

Physician/President

Phone

(256) 353-7775

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

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 3

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

• Samantha S Wyatt, M.D.

  • Dermatology Physician
  • Decatur, AL
  • NPI 1942247150
  Medicare reassignment NPD Authorized official
• Kaitlyn Blagburn, BA

  • Mental Health Counselor
  • Decatur, AL
  • NPI 1689420689
  NPD (past)
• Megan D James, RN

  • Registered Nurse
  • Decatur, AL
  • NPI 1265268650
  NPD (past)

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755734400000",
    "number": "1770782849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 WALNUT STREET NE",
            "address_2": "SUITE A",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356012456",
            "telephone_number": "256-353-7775",
            "fax_number": "256-353-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 WALNUT STREET NE",
            "address_2": "SUITE A",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356012456",
            "telephone_number": "256-353-7775",
            "fax_number": "256-353-7765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR DERMATOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2025-08-21",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "PHYSICIAN/PRESIDENT",
        "authorized_official_telephone_number": "256-353-7775",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529924440",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Debardlabon
• Decatur Ambulatory Surgery Center
• Decatur Caregiving Company LLC
• Decatur City
• Decatur Dental Center L.L.C.
• Decatur Diagnostic Laboratory, Inc.
• Decatur Digestive Diseases PC
• Decatur Emergency Physicians, Inc.
• Decatur EMS
• Decatur ENT Associates P C

• Dermatology Physician in Decatur, AL
• Providers in Decatur, AL by specialty
• Dermatology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.