SPRING BROOK DERMATOLOGY, LLC (NPI# 1639584519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639584519 |
| Entity Type | Organization |
| Organization Name | SPRING BROOK DERMATOLOGY, LLC |
| Practice Address |
5491 Roswell Rd Suite B Atlanta GA 30342-1911 |
| Mailing Address |
3707 Randall Mill Rd Nw Atlanta GA 30327-2713 |
| Practice Telephone | 5042315544 |
| Mailing Telephone | 5042315544 |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2014-06-30 |
| Authorized Official Name | DR. MARY M FELDMAN (OWNER) |
| Authorized Official Telephone | 5042315544 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 69403 | GA | Ambulatory Health Care Facilities |
| Street Address |
5491 ROSWELL RD SUITE B |
| City | ATLANTA |
| State | GA |
| Zip Code | 30342-1911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518943059 | Jon Darryl Pitts | Podiatrist | 5491 Roswell Rd, Ste B, Atlanta, GA 30342 | 2005-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820614 | Nia Charnice Griffin | Nurse Practitioner | 5670 Peachtree Dunwoodyroad, Suite 900, Atlanta, GA 30342 | 2020-10-26 |
| 1255945184 | Jennifer Lynne Cole | Behavior Technician | 5555 Glenridge Con Suite 200, Atlanta, GA 30342 | 2020-09-08 |
| 1093336232 | Van Tran | Respiratory Therapist, Registered | 1000 Johnson Ferry Rd Ne, Atlanta, Ga 30342, Atlanta, GA 30342 | 2020-04-28 |
| 1356978340 | Twyla Douglas Jackson I | Clinical Nutrition, 1000 Johnson Ferry Rd Ne, Atlanta, GA 30342 | 2020-03-27 | |
| 1760013411 | Emily Hamm | Dietitian, Registered | 933 D Johnson Ferry Road, Suite 250, Atlanta, GA 30342 | 2020-01-31 |
| 1043855984 | Mackenzie Tucker Wayda | Registered Nurse | 1001 Johnson Ferry Rd. Ne, Atlanta, GA 30342 | 2019-11-14 |
| 1386288454 | Tiauna Lashun Cochman | Psychologist | 1307 Glenridge Dr, Sandy Springs, GA 30342 | 2019-11-01 |
| 1164074399 | Stephen J. White | Hearing Instrument Specialist | 5775 Peachtree Dunwoody Rd Suite 600 Fl. 6, Uhc Hearing, Atl., GA 30342 | 2019-07-09 |
| 1144788142 | Jaytyn LLC | Internal Medicine | 4600 Broswell Road, Atlanta, GA 30342 | 2019-03-08 |
| 1760954705 | Mishele Walker LLC | Counselor | 555 Glenridge Connector, Suite 200, Sandy Springs, GA 30342 | 2018-12-31 |
| Find all providers in zip 30342 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 1194363382 | Arcd and Weightloss Management | Clinic/Center | 265 18th St Nw Ste 2823, Atlanta, GA 30363-1125 | 2019-12-18 |
| 1134775208 | Naesm Mens Health and Wellness Center | Clinic/Center | 2140 Martin Luther King Jr Dr Sw Ste 201, Atlanta, GA 30310 | 2019-08-14 |
| 1427532225 | River Acupuncture Inc | Clinic/Center | 5441 Buford Hwy Ne Ste 203, Atlanta, GA 30340-1168 | 2018-09-18 |
| 1093208381 | Tonova Audiometrics, LLC | Clinic/Center | 677b Alta Pl Nw, Atlanta, GA 30318-6364 | 2018-06-11 |
| 1841708682 | Aica Orthopedics, P.C. | Clinic/Center | 2045 Peachtree Rd Ne Ste 700, Atlanta, GA 30309-1417 | 2018-01-15 |
| 1407361702 | Buckhead Cosmetic and Family Dentistry LLC | Clinic/Center | 316 Pharr Rd Ne, Atlanta, GA 30305-2304 | 2017-12-08 |
| 1366952749 | Cancer Screening of America | Clinic/Center | 1 Baltimore Pl Nw Ste 240, Atlanta, GA 30308-2116 | 2017-10-11 |
| Find all providers in ATLANTA | ||||
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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.