NPIMap

Organization Active NPI

Dermatology Specialists of W Ga

  • Dermatology Physician
  • Carrollton, GA
National Provider Identifier
1780658203
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DERMATOLOGY SPECIALISTS OF W GA
Practice address
601 Dixie St
Carrollton, GA 30117-3816
Phone
(770) 838-9333
Fax
(770) 838-7755
NPI assigned
Feb 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Authorized official

Name
Sarah Jo Wilson, MDNPI 1588041099
Title
Owner/Managing Director
Phone
(770) 838-9333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X
Dermatopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0900X

Addresses

Primary practice location

601 Dixie St
Carrollton, GA 30117-3816

Mailing address

112 Wilshire Village Dr
Peachtree City, GA 30269-3138
Phone (770) 636-3376

Other practice location 1

112 Wilshire Village Dr
Peachtree City, GA 30269-3138
Phone (770) 636-3376 ext. 63376

Other practice location 2

354 Newnan Crossing Byp Ste 205
Newnan, GA 30265-2434
Phone (770) 520-8561

Other names 4

  • Newnan Dermatology Doing business as
  • Peachtree City Dermatology Doing business as
  • West Georgia Dermatology Doing business as
  • David E Schoenfeld MD, P.C. Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050628000964 GA Part B Supplier - Clinic/Group Practice 1456397660 Receives reassigned benefits from 11 practitioners
Practice locations: Carrollton, GA; Peachtree City, GA; Newnan, GA

National Provider Directory

National Provider Directory

Locations

354 Newnan Crossing Byp
Ste 205
Newnan, GA 30265
Phone (678) 326-4812

112 Wilshire Village Dr
Peachtree City, GA 30269
Phone 7706363376 ext. 63376

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775606400000",
    "number": "1780658203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 WILSHIRE VILLAGE DR",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302693138",
            "telephone_number": "770-636-3376",
            "fax_number": "770-838-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 DIXIE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173816",
            "telephone_number": "770-838-9333",
            "fax_number": "770-838-7755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 Wilshire Village Dr",
            "address_purpose": "LOCATION",
            "city": "Peachtree City",
            "state": "GA",
            "postal_code": "302693138",
            "country_code": "US",
            "telephone_number": "770-636-3376 x63376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "354 Newnan Crossing Byp Ste 205",
            "address_purpose": "LOCATION",
            "city": "Newnan",
            "state": "GA",
            "postal_code": "302652434",
            "country_code": "US",
            "telephone_number": "770-520-8561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DERMATOLOGY SPECIALISTS OF W GA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-13",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "OWNER/MANAGING DIRECTOR",
        "authorized_official_telephone_number": "770-838-9333",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newnan Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Peachtree City Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Georgia Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "David E Schoenfeld MD, P.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.