House of Dermatology, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

HOUSE OF DERMATOLOGY, LLC

Practice address

55 Roswell St Ste 110
Alpharetta, GA 30009-1979

Phone

(404) 721-2418

NPI assigned

Mar 30, 2022

Organization subpart

No

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

Authorized official

Name

Ravi R Patel, MDNPI 1245762103

Title

Owner

Phone

(706) 676-4836

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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 1

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

• Ravi Patel

  • Student in an Organized Health Care Education/Training Program
  • Lawrenceville, GA
  • NPI 1245762103
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648598400000",
    "number": "1972243780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5144 ARTEMESIA LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752096242",
            "telephone_number": "706-676-4836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 ROSWELL ST STE 110",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300091979",
            "telephone_number": "404-721-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSE OF DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-10",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "RAVI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-676-4836",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Darnell Howard Jr., DC
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• Dermatology Physician in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.