Organization Active NPI

Spectrum Dermatology of Atlanta

  • Dermatology Physician
  • Alpharetta, GA
National Provider Identifier
1821683616
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SPECTRUM DERMATOLOGY OF ATLANTA
Practice address
1725 Windward Concourse Ste 120
Alpharetta, GA 30005-3971
Phone
(470) 731-8010
Fax
(470) 731-8005
NPI assigned
Mar 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Authorized official

Name
Emma J Murad, MDNPI 1518143361
Title
Owner
Phone
(470) 731-8009

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

1725 Windward Concourse Ste 120
Alpharetta, GA 30005-3971

Mailing address

1725 Windward Concourse Ste 120
Alpharetta, GA 30005-3971
Phone (470) 731-8010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210312000461 GA Part B Supplier - Clinic/Group Practice 0941616189 Receives reassigned benefits from 3 practitioners
Practice locations: Alpharetta, GA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2228809Spectrum Dermatology of Atlanta, LLC1725 Windward Concourse, Suite 120, Alpharetta, GA 30005ComplianceMar 14, 2027

National Provider Directory

National Provider Directory

Locations

1725 Windward Concourse
Ste 120
Alpharetta, GA 30005
Phone (470) 731-8010

Interoperability endpoints

  • FHIR API: https://specdermatl.mmi.prod.fhir.ema-api.com/fhir/r4

Practitioners & affiliated clinicians

Practitioners 4

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": "1614816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1821683616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 WINDWARD CONCOURSE STE 120",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300053971",
            "telephone_number": "470-731-8010",
            "fax_number": "470-731-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 WINDWARD CONCOURSE STE 120",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300053971",
            "telephone_number": "470-731-8010",
            "fax_number": "470-731-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM DERMATOLOGY OF ATLANTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A",
        "authorized_official_last_name": "MURAD",
        "authorized_official_first_name": "EMMA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-731-8009",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.