AUGUSTA WEST DERMATOLOGY, LLC


Address: 3624 J Dewey Gray Cir, Suite 250, Augusta, GA 30909-6584
Phone: 7069227706

AUGUSTA WEST DERMATOLOGY, LLC (NPI# 1801272968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1801272968
Entity Type Organization
Organization Name AUGUSTA WEST DERMATOLOGY, LLC
Practice Address 3624 J Dewey Gray Cir
Suite 250
Augusta
GA 30909-6584
Practice Telephone 7069227706
Practice Fax Number 7069227999
Enumeration Date 2015-07-30
Last Update Date 2019-02-27
Authorized Official Name JEREMIAH MILLER (MANAGING MEMBER)
Authorized Official Telephone 7069227706
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207N00000X Dermatology 73843 GA Allopathic & Osteopathic Physicians

Office Location

Street Address 3624 J DEWEY GRAY CIR
SUITE 250
City AUGUSTA
State GA
Zip Code 30909-6584

Providers in the same location

NPI Name Taxonomy Address Enumeration
1649278219 John Paul Carr Family Medicine 3624 J Dewey Gray Cir, Suite 308, Augusta, GA 30909-6584 2005-07-08
1134374655 Amber Jordan Morris Physician Assistant 3624 J Dewey Gray Cir, Suite 103, Augusta, GA 30909-6584 2008-11-25
1942454863 Augusta Women's Health and Wellness Center Specialist 3624 J Dewey Gray Cir, Suite 240, Augusta, GA 30909-6584 2008-11-05
1952565210 Augusta Primary Care Services LLC Internal Medicine 3624 J Dewey Gray Cir, Suite 308, Augusta, GA 30909-6584 2008-07-16
1811175474 Augusta Primary Care Services, LLC Internal Medicine 3624 J Dewey Gray Cir, Suite 308, Augusta, GA 30909-6584 2008-02-06
1831212919 Amy Beth Shoemaker Specialist/Technologist 3624 J Dewey Gray Cir, Suite 308, Augusta, GA 30909-6584 2007-04-06
1508928367 Arnold Ray Christopher Preventive Medicine 3624 J Dewey Gray Cir, Suite 110, Augusta, GA 30909-6584 2006-12-15
1134228885 Philip William Catalano Specialist 3624 J Dewey Gray Cir, Suite 301, Augusta, GA 30909-6584 2006-09-21
1194837559 Daniel E Welch Specialist/Technologist 3624 J Dewey Gray Cir, Suite 302, Augusta, GA 30909-6584 2006-08-31
1972617744 Havon Knight Internal Medicine 3624 J Dewey Gray Cir, Suite 308, Augusta, GA 30909-6584 2006-08-18
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207N00000X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1134568520 Matthew Dean Belcher Dermatology 1120 15th St Fl 5, Augusta, GA 30912 2013-06-18
1073822607 Edward Hardin Smith Jr. Dermatology 514 Winchester Dr, Augusta, GA 30909-3236 2010-09-30
1093972325 Jeremiah Allan Miller IIi Dermatology 3624 J. Dewey Gray Circle, Suite 250, Augusta West Dermatology, Augusta, GA 30909 2008-05-22
1225235393 Sarah Josephson Cely Dermatology 820 Saint Sebastian Way Ste 6c, Augusta, GA 30901-2640 2007-07-02
1649349978 Augusta Dermatology Associates PC Dermatology 820 St Sebastian Way Ste 6c, Augusta, GA 30901 2006-11-08
1215923073 Barry L Thompson Dermatology 2060 Central Ave, Augusta, GA 30904-4177 2005-09-26
1437142072 Fred Jason Kight Dermatology 1248 Augusta West Pkwy, Augusta, GA 30909-1854 2005-08-30
1720516560 James Petit Dermatology 1004 Chafee Ave, Augusta, GA 30904 2017-05-24
1427431048 Rachel Marks Greenwood Dermatology 950 15th St, Augusta, GA 30901-2608 2015-07-01
1356738199 Mario Maruthur Dermatology 1120 15th St, Augusta, GA 30912-1059 2015-04-20
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City AUGUSTA
Zip Code 30909

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Dataset Information

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.

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