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GOODMAN DERMATOLOGY, SKIN CANCER SPECIALISTS PC & AESTHETICS CENTER
NPI 1114022167
Dermatology in Marietta, GA

Active since September 14, 2006CLIA Certified · 3 labs
835 COGBURN AVE NW, SUITE 100, MARIETTA, GA 30060(770) 422-5557(770) 422-5456 Get Directions Write a Review

NPPES record last updated: September 16, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Goodman Dermatology, Skin Cancer Specialists Pc & Aesthetics Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GOODMAN DERMATOLOGY, SKIN CANCER SPECIALISTS PC & AESTHETICS CENTER (NPI 1114022167) is a healthcare organization registered as a dermatology in Marietta, Georgia and active in the NPI registry since September 2006. The organization holds 3 active CLIA laboratory certificates and lists Theodore Schiff, Owner, as its authorized official.

NPPES Registry Identity

NPI1114022167
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameAQUA DERMATOLOGY OF GEORGIA PC
Location Address835 COGBURN AVE NW, SUITE 100Marietta, GA 30060-1031
Mailing Address835 Cogburn Ave Nw, Suite 100Marietta, GA 30060-1031 · (770) 422-5557 · Fax (770) 422-5456
Phone(770) 422-5557
Fax(770) 422-5456
Organization SubpartNo
Authorized OfficialTheodore SchiffOwner · (770) 422-5557
Enumeration DateSeptember 14, 2006
Last NPPES UpdateSeptember 16, 2024
NPPES CertifiedSeptember 16, 2024
✔ NPI 1114022167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
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.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
835 COGBURN AVE NW, Marietta, GA 30060
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Other Names 1

Doing Business AsGoodman Dermatology, Skin Cancer Specialists Pc & Aesthetics Center

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 3

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 11D1016973

Aqua Dermatology Of Georgia , PC · Marietta, GA
Active · expires Nov 16, 2027
CLIA Number11D1016973
Laboratory TypePhysician Office
Certificate Effective DateNovember 17, 2025
Certificate Expiration DateNovember 16, 2027
Laboratory DirectorMark A. Chastain MD
Laboratory Phone(678) 738-0122
Laboratory LocationAqua Dermatology Of Georgia , PC835 Cogburn Avenue, Marietta, GA 30060
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 11D2235821

Aqua Dermatology Of Georgia - Hiram Dba Skin Cancer Specialists & Aesthetics · Dallas, GA
Active · expires Jun 13, 2027
CLIA Number11D2235821
Laboratory TypePhysician Office
Certificate Effective DateJune 14, 2025
Certificate Expiration DateJune 13, 2027
Laboratory DirectorMark A. Chastain
Laboratory Phone(770) 422-5557
Laboratory LocationAqua Dermatology Of Georgia - Hiram Dba Skin Cancer Specialists & Aesthetics850 Charles Hardy Parkway, Dallas, GA 30157
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 11D1059972

Aqua Dermatology Of Georgia - Newnan Dba Skin Cancer Specialists PC · Newnan, GA
Active · expires Apr 2, 2027
CLIA Number11D1059972
Laboratory TypePhysician Office
Certificate Effective DateApril 3, 2025
Certificate Expiration DateApril 2, 2027
Laboratory DirectorMark A. Chastain
Laboratory Phone(770) 422-5557
Laboratory LocationAqua Dermatology Of Georgia - Newnan Dba Skin Cancer Specialists PC2045 Highway 34 East, Newnan, GA 30265
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MATTHEW PRESTON HUGHES M.D
Dermatology
835 COGBURN AVE NW, SUITE 250
MARIETTA, GA 30060
Cobb County (770) 422-8815
DR. JENNIFER LOUISE BUCKLEY MD
Dermatology
835 COGBURN AVE NW, SUITE 100
MARIETTA, GA 30060
Cobb County (770) 422-5557
CAROLYN M SIMS PA-C
Physician Assistant (Medical)
835 COGBURN AVE NW, SUITE 100
MARIETTA, GA 30060
Cobb County (770) 422-5557
ASHLEY M ADES PA-C
Physician Assistant
835 COGBURN AVE NW, SUITE 100
MARIETTA, GA 30060
Cobb County (770) 422-5557
ALEXANDRA PALGON PA-C
Physician Assistant
835 COGBURN AVE NW, SUITE 100
MARIETTA, GA 30060
Cobb County (770) 422-5557
DR. ANITA KANITHAHALLI SHETTY M.D.
Dermatology
835 COGBURN AVE NW, SUITE 100
MARIETTA, GA 30060
Cobb County (770) 422-5557
BRIDGET M SROKA PA-C
Physician Assistant (Medical)
835 COGBURN AVE NW, SUITE 100
MARIETTA, GA 30060
Cobb County (770) 422-5557
DR. MARK ALAN CHASTAIN MD
Dermatology
835 COGBURN AVE NW, SUITE 100
MARIETTA, GA 30060
Cobb County (770) 422-5557

Frequently 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 Aqua Dermatology Of Georgia PC's NPI number?

The NPI number for Aqua Dermatology Of Georgia PC is 1114022167. It was assigned to this organization in the NPPES registry on September 14, 2006. The provider is doing business as Goodman Dermatology, Skin Cancer Specialists PC & Aesthetics Center.

Where is Aqua Dermatology Of Georgia PC located?

Aqua Dermatology Of Georgia PC is located at 835 Cogburn Ave NW Suite 100, Marietta, GA 30060. The listed phone number is (770) 422-5557.

What is Aqua Dermatology Of Georgia PC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Aqua Dermatology Of Georgia PC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Aqua Dermatology Of Georgia PC 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 Aqua Dermatology Of Georgia PC 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 Aqua Dermatology Of Georgia PC was last updated on September 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.