DR. PATRICK DAVID RETTERBUSH (NPI# 1700176211) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700176211 |
| Entity Type | Individual |
| Full Name | DR. PATRICK DAVID RETTERBUSH |
| Credential | M.D. |
| Practice Address |
1500 Oglethorpe Ave Ste 300a Athens GA 30606-2181 |
| Practice Telephone | 7066141750 |
| Practice Fax Number | 7064804185 |
| Mailing Telephone | 7066141750 |
| Mailing Fax Number | 7064804185 |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2019-05-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 73445 | GA | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
73445 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
1500 OGLETHORPE AVE STE 300A |
| City | ATHENS |
| State | GA |
| Zip Code | 30606-2181 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275696148 | Stephen Alan Schacher | Preventive Medicine | 1500 Oglethorpe Ave Ste 300a, Athens, GA 30606-2181 | 2006-12-19 |
| 1700357019 | Patrick D Retterbush Md LLC | Dermatology | 1500 Oglethorpe Ave Ste 300a, Athens, GA 30606-2181 | 2018-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942816962 | Kofi Darkwa Seffah | Student in an Organized Health Care Education/Training Program | 1199 Prince Ave #70, 1270 Prince Ave Suite 201, Athens, GA 30606 | 2020-09-16 |
| 1831712363 | Rebecca John | Licensed Practical Nurse | 240 Mitchel Bridge Road, Athens, GA 30606 | 2020-05-19 |
| 1497375612 | Alfred Ka-shing Wong | Student in an Organized Health Care Education/Training Program | 1270 Prince Ave Suite 201, Athens, GA 30606 | 2020-04-17 |
| 1881223956 | Lauren Fesperman | Nurse Practitioner | 242 King Ave Ste 130, Athens, GA 30606 | 2020-04-02 |
| 1255966081 | Westminster Presbyterian Homes, Inc. | Skilled Nursing Facility | 1400 Live Oak Ln, Building 100, Athens, GA 30606 | 2020-03-12 |
| 1255981700 | Carol Cameron Cready-pyle | Social Worker | 1551 Jennings Mill Pkwy Ste 1700, Athens, GA 30606 | 2019-09-17 |
| 1013576016 | Lauren Gruendling | Nurse Practitioner | 242 King Avenue, Suite 210, Athens, GA 30606 | 2019-06-12 |
| 1760045223 | Dominic Ofosu Amakye | Student in an Organized Health Care Education/Training Program | 1270 Prince Avenue Suite 201, Athens, GA 30606 | 2019-04-19 |
| 1740740422 | Juan G Salazar Castillo | Student in an Organized Health Care Education/Training Program | Community Internal Medicine of Athens, 1500 Oglethorpe Ave Suite 200d, Athens, GA 30606 | 2019-03-20 |
| 1750869020 | Jennifer Emily Chapman | Physical Therapist | 1021 Parkway Blvd Ste 101, Athens, GA 30606 | 2018-07-30 |
| Find all providers in zip 30606 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245572643 | Valerie Lananh Truong | Dermatology | 3193 Howell Mill Rd Nw Ste 220, Atlanta, GA 30327 | 2013-03-23 |
| 1063668762 | Medical Services of Northern Georgia, Inc. | Dermatology | 4060 Peachtree Rd Ne, #d284, Atlanta, GA 30319-3020 | 2008-08-13 |
| 1720189293 | Janice Murphy Warner | Dermatology | 1550 Mulkey Rd, Austell, GA 30106 | 2006-09-26 |
| 1215973482 | Ross M Campbell | Dermatology | 1180 Resurgence Dr, Suite 100, Watkinsville, GA 30677-7210 | 2006-06-22 |
| 1366409880 | John David Kayal | Dermatology | 2366 Habersham Dr Sw, Marietta, GA 30064-3804 | 2006-04-27 |
| 1902881659 | Karen R Maffei | Dermatology | 1050 Thomas Ave, Watkinsville, GA 30677-6071 | 2005-12-14 |
| 1023015690 | Diamondis John Papadopoulos | Dermatology | 875 Johnson Ferry Rd Ne, Ste 300, Atlanta, GA 30342-1418 | 2005-06-28 |
| 1154938579 | Forefront Dermatology, S.c. | Dermatology | 7000 Wellness Way Ste 7120, St Simons Island, GA 31522-2286 | 2020-09-29 |
| 1710449079 | Forefront Dermatology, S.c. | Dermatology | 5505 Peachtree Dunwoody Rd Ste 412, Atlanta, GA 30342-1758 | 2019-04-04 |
| 1245780980 | Baucom & Mina Derm Surgery, LLC | Dermatology | 5555 Peachtree Dunwoody Rd, Suite 206, Atlanta, GA 30342-1703 | 2016-10-06 |
| Find all providers with the same taxonomy | ||||
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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.