Misty Dawn Caudell, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

058402 Issued in GA

Practice address

1498 Jesse Jewell Pkwy SE Ste D
Gainesville, GA 30501-3874

Phone

(770) 535-7546

Fax

(770) 535-7591

NPI assigned

Feb 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Medical College of Georgia School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgia Skin Cancer and Aestheitic Dermatology, LLCGroup PAC ID 0244328649, 25 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029

Merit-based Incentive Payment System (MIPS)

Final score

85.62 of 100Reported as group

Quality

78.23

Promoting interoperability

100

Improvement activities

40

Cost

73.84

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mcaudell1@georgiaderm.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Georgia Skin Cancer & Aestheitic Dermatology, LLC

  • Dermatology Physician
  • Watkinsville, GA
  • NPI 1205026168
  Medicare reassignment Care Compare group NPD
• Skin Center of Georgia, PC

  dba Georgia Skin Center

  • Dermatology Physician
  • Gainesville, GA
  • NPI 1407215817
  Authorized official Same address or phone
• Douglas a. Thomas, MD

  dba Thomas Dermatology

  • Dermatology Physician
  • Las Vegas, NV
  • NPI 1891897658
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northeast Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, GA
  • NPI 1427055821
  Care Compare affiliation

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672617600000",
    "number": "1821060781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1456",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305031456",
            "telephone_number": "770-535-7546",
            "fax_number": "770-535-7591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1498 JESSE JEWELL PKWY SE STE D",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013874",
            "telephone_number": "770-535-7546",
            "fax_number": "770-535-7591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAUDELL",
        "first_name": "MISTY",
        "middle_name": "DAWN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-06",
        "last_updated": "2023-01-02",
        "certification_date": "2023-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD425726",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NV",
            "license": "15031",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "058402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101343342",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Armando R Castillo Jr., MD
• Natali Castillo, CPHT
• Leigh Ann Castleberry, CRNA
• Ximena Ariela Castro, AGNP-C
• Lindsey A Caudell
• Keith Eugene Causey, PA
• Becky Adams Caverzasi, APRN
• Geetha Mariah Cawthon, MD
• Hee Jin Cayetano, PA-C, RD, LD
• Cedar Dental Clinical I, LLC (Orthodontic Care of Georgia)

• Dermatology Physician in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.