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BAUCOM & MINA DERM SURGERY, LLC
NPI 1245780980
Dermatology - MOHS-Micrographic Surgery in Atlanta, GA

Active since October 06, 2016CLIA Certified · 2 labs
5555 PEACHTREE DUNWOODY RD, SUITE 206, ATLANTA, GA 30342(404) 844-0496(404) 844-0499 Get Directions Write a Review

NPPES record last updated: December 13, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 13, 2023, Dec 4, 2018 (2 updates tracked since 2018).

About Baucom & Mina Derm Surgery, Llc NPPES

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

BAUCOM & MINA DERM SURGERY, LLC (NPI 1245780980) is a healthcare organization registered as a mohs-micrographic surgery in Atlanta, Georgia and active in the NPI registry since October 2016. The organization holds 2 active CLIA laboratory certificates and lists Mary Alice Mina, Owner, as its authorized official.

NPPES Registry Identity

NPI1245780980
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameBAUCOM & MINA DERM SURGERY, LLC
Location Address5555 PEACHTREE DUNWOODY RD, SUITE 206Atlanta, GA 30342-1703
Mailing Address5555 Peachtree Dunwoody Rd, Suite 206Atlanta, GA 30342-1703
Phone(404) 844-0496
Fax(404) 844-0499
Organization SubpartNo
Authorized OfficialMary Alice MinaOwner · (404) 844-0496
Enumeration DateOctober 6, 2016
Last NPPES UpdateDecember 13, 20232 updates tracked since enumeration
NPPES CertifiedDecember 13, 2023
✔ NPI 1245780980 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
Definition
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.
5555 PEACHTREE DUNWOODY RD, Atlanta, GA 30342
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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 SINGLE SPECIALTY GROUP

Accepted Insurance

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

CLIA Laboratory Certificates CMS CLIA 2

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 11D0906008

Baucom And Mina Derm Surgery, LLC · Atlanta, GA
Active · expires Nov 13, 2027
CLIA Number11D0906008
Laboratory TypePhysician Office
Certificate Effective DateNovember 14, 2025
Certificate Expiration DateNovember 13, 2027
Laboratory DirectorMark F. Baucom
Laboratory Phone(404) 844-0496
Laboratory LocationBaucom And Mina Derm Surgery, LLC5555 Peachtree Dunwoody Road Suite 206, Atlanta, GA 30342
CLIA data matches this NPI record on: Address 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 11D2180746

Baucom & Mina Derm Surgery, LLC · Johns Creek, GA
Active · expires Dec 17, 2026
CLIA Number11D2180746
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateDecember 18, 2024
Certificate Expiration DateDecember 17, 2026
Laboratory DirectorMark F. Baucom
Laboratory Phone(404) 844-0496
Laboratory LocationBaucom & Mina Derm Surgery, LLC10750 Medlock Bridge Road, Suite 101, Johns Creek, GA 30097
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 20

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

JM CARDINAL INVESTMENTS LLC MEDICAL QUARTERS
Pharmacy (Community/Retail Pharmacy)
5555 PEACHTREE DUNWOODY RD
ATLANTA, GA 30342
Fulton County (404) 252-3607
MRS. KRYSTYN DUNN BULLOCK OT
Occupational Therapist
5555 PEACHTREE DUNWOODY RD, SUITE 225
ATLANTA, GA 30342
Fulton County (404) 835-3340
DEANNA HORTMAN CAMILO DPT
Physical Therapist
5555 PEACHTREE DUNWOODY RD, ST 225
ATLANTA, GA 30342
Fulton County (404) 835-3340
DR. MICHAEL B. STEWART D.D.S.
Dentist (Orthodontics and Dentofacial Orthopedics)
5555 PEACHTREE DUNWOODY RD, SUITE 301
ATLANTA, GA 30342
Fulton County (404) 255-5454
KATHRYN FILIPEK P.A.-C
Physician Assistant
5555 PEACHTREE DUNWOODY RD, STE 190
ATLANTA, GA 30342
Fulton County (404) 256-4457
ANDREA CARMIN PT
Physical Therapist
5555 PEACHTREE DUNWOODY RD, SUITE 225
ATLANTA, GA 30342
Fulton County (404) 835-3340
CHRISTOPHER D TAYLOR M.D.
Pain Medicine (Interventional Pain Medicine)
5555 PEACHTREE DUNWOODY RD, STE G99
ATLANTA, GA 30342
Fulton County (404) 843-3323
STEPHANIE PAPPAS MD
Colon & Rectal Surgery
5555 PEACHTREE DUNWOODY RD, SUITE 206
ATLANTA, GA 30342
Fulton County (404) 851-2422

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 Baucom & Mina Derm Surgery, LLC's NPI number?

The NPI number for Baucom & Mina Derm Surgery, LLC is 1245780980. It was assigned to this organization in the NPPES registry on October 6, 2016.

Where is Baucom & Mina Derm Surgery, LLC located?

Baucom & Mina Derm Surgery, LLC is located at 5555 Peachtree Dunwoody Rd Suite 206, Atlanta, GA 30342. The listed phone number is (404) 844-0496.

What is Baucom & Mina Derm Surgery, LLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Does Baucom & Mina Derm Surgery, LLC hold CLIA laboratory certificates?

Yes. 2 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 Baucom & Mina Derm Surgery, LLC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Baucom & Mina Derm Surgery, LLC 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 Baucom & Mina Derm Surgery, LLC was last updated on December 13, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.