AUGUSTA CENTRE FOR DERMATOLOGY & SKIN RENEWAL LLC (NPI# 1255702940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255702940 |
| Entity Type | Organization |
| Organization Name | AUGUSTA CENTRE FOR DERMATOLOGY & SKIN RENEWAL LLC |
| Practice Address |
3614 J Dewey Gray Cir Ste B Augusta GA 30909-6602 |
| Practice Telephone | 7064473909 |
| Mailing Telephone | 7064473909 |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2015-10-07 |
| Authorized Official Name | MRS. ANNE M LOEBL (OWNER) |
| Authorized Official Telephone | 7064473909 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
022436 | GA | Ambulatory Health Care Facilities |
| Street Address |
3614 J DEWEY GRAY CIR STE B |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30909-6602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275503872 | Andrew E Dick | Specialist | 3614 J Dewey Gray Cir, Suite B, Augusta, GA 30909-6602 | 2006-01-25 |
| 1629588199 | Santana Maria Robinson | Nurse Practitioner | 3614 J Dewey Gray Cir, Augusta, GA 30909-6602 | 2017-10-10 |
| 1750775789 | Southern Internal Medicine Critical Care Associates, LLC | Internal Medicine | 3614 J Dewey Gray Cir, Bulding B, Augusta, GA 30909-6602 | 2015-03-27 |
| 1124235536 | Rodolfo Rozindo Machado | Internal Medicine | 3614 J Dewey Gray Cir, Suite A, Augusta, GA 30909-6602 | 2007-05-16 |
| 1093803686 | Kenneth W Reeves | Internal Medicine | 3614 J Dewey Gray Cir, Ste A, Augusta, GA 30909-6602 | 2006-10-10 |
| 1467563395 | Anne M. Loebl | Dermatology | 3614 J Dewey Gray Cir, Suite B, Augusta, GA 30909-6602 | 2006-08-31 |
| 1942244652 | Tito C Sobrinho | Pediatrics | 3614 J Dewey Gray Cir, Augusta, GA 30909-6602 | 2006-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513888 | Lauran Simpson | Behavior Technician | 1237 Augusta West Parkway, Augusta, GA 30909 | 2020-09-16 |
| 1487273884 | Still Perspectives Counseling LLC | Counselor | 1265 Inerstate Prwy, Suite B, Augusta, GA 30909 | 2020-04-15 |
| 1598397838 | Mjra Medical LLC | Psychologist | 3675 J Dewey Gray Cr Ste 300, Augusta, GA 30909 | 2020-02-05 |
| 1003452319 | Danny Robinson | Counselor | 2609 Commons Boulevard, Augusta, GA 30909 | 2019-11-21 |
| 1407498637 | Candice M Cruse | Social Worker | 2609 Commons Blvd, Augusta, GA 30909 | 2019-10-09 |
| 1902363385 | Mary D Jodon | Pharmacist | 3338 Wrightsboro Rd., Augusta, GA 30909 | 2019-02-21 |
| 1447790514 | Burn Critical Care Associates, LLC | Internal Medicine | 3614 J. Dewey Gray Circle, Bldg B., Augusta, GA 30909 | 2017-03-08 |
| 1124561766 | Sasha Latara Mccraw | Counselor | 7303 Palomino Court, Augusta, GA 30909 | 2016-11-30 |
| 1174974620 | Warren Umansky, Ph.d. | Psychologist | 302 Wheeler Executive Ctr, Augusta, GA 30909 | 2016-06-27 |
| 1811358955 | Theodora Mcleskey | Nurse Practitioner | 1215 George C. Wilson Drive, Augusta, GA 30909 | 2016-03-17 |
| Find all providers in zip 30909 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
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| 1114964467 | Arthritis & Rheumatism Care PC | Clinic/Center | 820 Saint Sebastian Way, Pob 1 5a, Augusta, GA 30901-2643 | 2006-06-02 |
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| 1528601200 | Blued Consultant Solutions, LLC | Clinic/Center | 256 Rainbow Ln, Mcdonough, GA 30252-4839 | 2019-10-24 |
| 1578113585 | Centro Prenatal De Gwinnett LLC | Clinic/Center | 575 W Pike St Ste 1, Lawrenceville, GA 30046-7685 | 2019-09-12 |
| 1316508815 | Atlanta Health Clinic LLC | Clinic/Center | 2480 Windy Hill Rd Se Ste 404, Marietta, GA 30067-8658 | 2019-06-25 |
| 1659880847 | Jones Medical and Educational Consultants | Clinic/Center | 8954 Hospital Dr Bldg C, Douglasville, GA 30134-2200 | 2017-09-20 |
| 1477005593 | Hirenirali LLC | Clinic/Center | 12390 Beragio Pl, Alpharetta, GA 30004-4188 | 2016-10-25 |
| 1851840961 | Tele Doctor Direct Inc | Clinic/Center | 1250 Powers Ferry Cmn Se, Suite 100, Marietta, GA 30067-6046 | 2016-09-30 |
| 1154870533 | Life Point Medical, LLC | Clinic/Center | 189 Bo James Street, Suite 105, Clayton, GA 30525 | 2016-09-27 |
| 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.