GEORGIA DERMATOLOGY & SKIN CANCER CENTER, LLC (NPI# 1063460459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063460459 |
| Entity Type | Organization |
| Organization Name | GEORGIA DERMATOLOGY & SKIN CANCER CENTER, LLC |
| Other Organization Name | GEORGIA DERMATOLOGY & SKIN CARE CENTER |
| Practice Address |
2400 Bellevue Rd 16 Erin Office Park Dublin GA 31021-2885 |
| Mailing Address |
2400 Bellevue Rd Ste 21a Dublin GA 31021-2890 |
| Practice Telephone | 4783280281 |
| Practice Fax Number | 4783280438 |
| Mailing Telephone | 4783280281 |
| Mailing Fax Number | 4783280438 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2007-10-30 |
| Authorized Official Name | MICHAEL J SHARKEY (OWNER) |
| Authorized Official Telephone | 4782752694 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZD0900X |
Pathology Specialization: Dermatopathology |
Allopathic & Osteopathic Physicians | ||
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
Allopathic & Osteopathic Physicians | ||
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
Allopathic & Osteopathic Physicians | ||
| N | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
Allopathic & Osteopathic Physicians | ||
| N | 207NI0002X |
Dermatology Specialization: Clinical & Laboratory Dermatological Immunology |
Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | RAILROAD MEDICARE | DC4061 | 01 |
| Other Name | Type Code |
|---|---|
| Georgia Dermatology & Skin Care Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427614577 | Georgia Dermatology & Skin Cancer Center, LLC | Dermatology | 2110 Woodside Executive Court, Aiken, SC 29803-3809 | 2019-05-14 |
| Street Address |
2400 BELLEVUE RD 16 ERIN OFFICE PARK |
| City | DUBLIN |
| State | GA |
| Zip Code | 31021-2885 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538167523 | Tonya B Nicholson | Advanced Practice Midwife | 2400 Bellevue Rd, Erin Office Suite 26, Dublin, GA 31021-2885 | 2005-07-13 |
| 1619576253 | Rachel Westerbeck | Physician Assistant | 2400 Bellevue Rd, Dublin, GA 31021-2885 | 2020-10-24 |
| 1750906103 | Brandon Brown | Dentist | 2400 Bellevue Rd, Dublin, GA 31021-2885 | 2020-06-11 |
| 1942747274 | Jill Pavesich | Nurse Practitioner | 2400 Bellevue Rd, Suite 26, Dublin, GA 31021-2885 | 2017-01-25 |
| 1457759508 | Family Dentistry of Dublin, P.C. | Dentist | 2400 Bellevue Rd, #24, Dublin, GA 31021-2885 | 2014-12-05 |
| 1851724256 | Billy H Moses Jr Md LLC | Surgery | 2400 Bellevue Rd, #11 Erin Office Park, Dublin, GA 31021-2885 | 2013-08-21 |
| 1508124249 | Dublin Womens Center | Obstetrics & Gynecology | 2400 Bellevue Rd, Erin Office Park 26, Dublin, GA 31021-2885 | 2012-05-01 |
| 1396023404 | Dublin Dialysis Center LLC | Clinic/Center | 2400 Bellevue Rd, Suite 29a, Dublin, GA 31021-2885 | 2011-07-25 |
| 1659670982 | Kathryn Falk Johnson | Optometrist | 2400 Bellevue Rd, 18 Erin Office Park, Dublin, GA 31021-2885 | 2011-03-25 |
| 1770894867 | Felicia Fountain | Ophthalmology | 2400 Bellevue Rd, 18 Erin Office Park, Dublin, GA 31021-2885 | 2010-06-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497213748 | Ronald E. Johnson | Peer Specialist | Carl Vinson Va Medical Center, 1826 Veterans Blvd., Dublin, GA 31021 | 2019-03-06 |
| 1902384811 | Nieka Jackson | Pharmacist | 75 Woodlawn Dr, Apt. C-1, Dublin, GA 31021 | 2018-08-02 |
| 1407341522 | Empower Psychiatry & Weight Loss, LLC | Nurse Practitioner | 112 Rowe St Ste B, Dublin, GA 31021 | 2018-06-30 |
| 1619462207 | Kara Emily Frost | Speech-Language Pathologist | 1406 Bellevue Rd, Dublin, GA 31021 | 2018-06-26 |
| 1376035410 | Owens Speech Services, LLC | Speech-Language Pathologist | 401 Barfield Court, Dublin, GA 31021 | 2018-06-05 |
| 1558878884 | Tattnall Hospital Company, LLC | Neurological Surgery | 242 Industrial Blvd, Dublin, GA 31021 | 2018-01-09 |
| 1376991000 | Eatonton Facility Development Company, LLC | Hospice, Inpatient | 155 Greensboro Rd, Eatonton, GA 31021 | 2016-06-03 |
| 1801261177 | Jones Community Health Center, LLC | Clinic/Center | 115 Shadow Pond, Dublin, GA 31021 | 2015-12-11 |
| 1508237561 | Cancer Center of Middle Georgia | Specialist | 26 Erin Office Park, Dublin, GA 31021 | 2015-10-15 |
| 1922477249 | Mickey Jackson | Non-emergency Medical Transport (VAN) | 610 John Robinson Tl., Dublin, GA 31021 | 2015-09-16 |
| Find all providers in zip 31021 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770048894 | Teresa O'connell | Dermatology | Timeless Skin Solutions, 31 South High St, Dublin, OH 43017 | 2019-02-02 |
| 1649629692 | Megan Ashley Jones-sheets | Dermatology | 75 Metro Place North, Suite 195, Dublin, OH 43017 | 2016-06-10 |
| 1528405586 | Jessica V Hoy | Dermatology | 7450 Hospital Dr Ste 370, Dublin, OH 43016-9629 | 2013-05-31 |
| 1043455595 | Yang Shen | Dermatology | 5720 Blazer Pkwy, Dublin, OH 43017-3566 | 2008-12-12 |
| 1962552703 | Sandra Elizabeth Bendeck Rydell | Dermatology | 5300 Ironhorse Pkwy, # 371, Dublin, CA 94568-2043 | 2007-01-12 |
| 1366504656 | Dermatology and Cosmetic Surgery of Dublin, Inc | Dermatology | 6905 Hospital Drive Road, Suite 230, Dublin, OH 43016 | 2006-12-14 |
| 1568560456 | Buckeye Dermatology Inc | Dermatology | 5080 Bradenton Ave, Ste B, Dublin, OH 43017-3520 | 2006-09-21 |
| 1891805339 | Mary Beth Luca | Dermatology | 6740 Perimeter Dr Ste 100, Dublin, OH 43016-8074 | 2006-08-30 |
| 1003891052 | Michael P Conroy | Dermatology | 7450 Hospital Drive, Ste 370, Dublin, OH 43016-9624 | 2005-12-13 |
| 1558355693 | Jason Glen Arnold | Dermatology | 2400 Bellevue Rd Ste 21a, Dublin, GA 31021-2890 | 2005-09-06 |
| Find all providers in DUBLIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.