JOHNS CREEK DERMATOLOGY AND FAMILY MEDICINE, P.C.
NPI 1053565580
Dermatology in Johns Creek, GA
About Johns Creek Dermatology And Family Medicine, P.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JOHNS CREEK DERMATOLOGY AND FAMILY MEDICINE, P.C. (NPI 1053565580) is a healthcare organization registered as a dermatology in Johns Creek, Georgia and active in the NPI registry since November 2008. The organization holds a CLIA Certificate of Compliance certificate valid through October 2, 2027 and lists Shereen Timani, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Other Identifiers 4
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Johns Creek Dermatology And Family Medicine, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Johns Creek Dermatology And Family Medicine, P.C., which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Johns Creek, GA 30097
Johns Creek, GA 30097
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Compliance 11D1096403
Johns Creek Dermatology And Family Medicine PC · Duluth, GAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Johns Creek Dermatology And Family Medicine, P.C.'s NPI number?
The NPI number for Johns Creek Dermatology And Family Medicine, P.C. is 1053565580. It was assigned to this organization in the NPPES registry on November 11, 2008.
Where is Johns Creek Dermatology And Family Medicine, P.C. located?
Johns Creek Dermatology And Family Medicine, P.C. is located at 6300 Hospital Pkwy Ste 100, Johns Creek, GA 30097. The listed phone number is (770) 771-6591.
What is Johns Creek Dermatology And Family Medicine, P.C.'s specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Johns Creek Dermatology And Family Medicine, P.C. enrolled in Medicare?
Yes. Johns Creek Dermatology And Family Medicine, P.C. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Johns Creek Dermatology And Family Medicine, P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Johns Creek Dermatology And Family Medicine, P.C., in Dermatology and Family Practice. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Johns Creek Dermatology And Family Medicine, P.C. hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 11D1096403) is associated with this NPI, valid through October 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Johns Creek Dermatology And Family Medicine, P.C. accept?
Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Johns Creek Dermatology And Family Medicine, P.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Johns Creek Dermatology And Family Medicine, P.C. was last updated on October 5, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Johns Creek Dermatology And Family Medicine, P.c. · NPI 1053565580
Dermatology organization in Johns Creek, Georgia. Organization record, active in the CMS NPPES registry since November 11, 2008.
## Identity
- **NPI:** 1053565580 (Entity type: Organization)
- **Enumerated:** November 11, 2008
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Shereen Timani, OWNER
## Practice location
- **Address:** 6300 HOSPITAL PKWY, STE 100, Johns Creek, GA 30097
- **Phone:** (770) 771-6591 · **Fax:** (770) 771-6599
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (1), Family Practice (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 5, 2010
- **Other identifiers:** Medicaid 437442038A (GA); Medicare PIN 511G41701297 (GA); Other 1851505077 (GA); and 1 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1053565580) · Data from the CMS NPPES public registry.