Atlanta Skin and Aesthetics

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

Legal business name

ATLANTA SKIN AND AESTHETICS

Doing business as

Atlanta Skin and Aesthetics

Practice address

5671 Peachtree Dunwoody Rd Ste 660
Atlanta, GA 30342-5006

Phone

(404) 252-4110

Fax

(404) 252-2188

NPI assigned

Oct 5, 2007

Last updated

Sep 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Richard Edgar Nix Jr.

Title

Business Manager

Phone

(404) 252-4110

Specialties & licenses 1

Addresses

Other names 1

• Atlanta Skin and Aesthetics Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 4

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.

• Jay A Levin, MD

  • Dermatology Physician
  • Atlanta, GA
  • NPI 1467406082
  Medicare reassignment NPD
• Dora McIver Broom, PA-C

  • Physician Assistant
  • Woodstock, GA
  • NPI 1144642844
  NPD (past)
• David F Rodriguez, M.D.

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1376656447
  NPD (past)
• Chelsie Rogers, PA-C

  • Dermatology Physician
  • Atlanta, GA
  • NPI 1366952707
  NPD (past)

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1780872556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FERRY RD STE 465",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421709",
            "telephone_number": "404-252-4110",
            "fax_number": "404-252-2188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5671 PEACHTREE DUNWOODY RD STE 660",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303425006",
            "telephone_number": "404-252-4110",
            "fax_number": "404-252-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA SKIN AND AESTHETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "NIX",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "EDGAR",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "404-252-4110",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlanta Skin and Aesthetics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Atlanta Skin and Aesthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Atlanta Regional Commission
• Atlanta Relationship Institute
• Atlanta Reset Therapy
• Atlanta Retina PC
• Atlanta Skin & Aesthetics, LLC
• Atlanta Skin Wellness Center LLC (Atlanta Skin Wellness)
• Atlanta Sleep Medicine Clinic, LLC
• Atlanta Smiles & Wellness LLC
• Atlanta Southeast Center for Epilepsy & Neurodevelopment, PC (Ascend)
• Atlanta Speech & Language Therapy, LLC

• Procedural Dermatology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Procedural Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.