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SURGICAL & COSMETIC DERMATOLOGY, P. C.
NPI 1396087680
Dermatology - MOHS-Micrographic Surgery in Newnan, GA

Active since March 25, 2013CLIA Certified · 2 labs
1615 HIGHWAY 34 E STE B, NEWNAN, GA 30265(770) 400-8400(770) 400-8401 Get Directions Write a Review

NPPES record last updated: August 14, 2019. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Surgical & Cosmetic Dermatology, P. C. NPPES

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

SURGICAL & COSMETIC DERMATOLOGY, P. C. (NPI 1396087680) is a healthcare organization registered as a mohs-micrographic surgery in Newnan, Georgia and active in the NPI registry since March 2013. The organization holds 2 active CLIA laboratory certificates, maintains 2 additional practice locations, and lists Daivid Thomas Harvey, Physician, as its authorized official.

NPPES Registry Identity

NPI1396087680
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameSURGICAL & COSMETIC DERMATOLOGY, P. C.
Location Address1615 HIGHWAY 34 E STE BNewnan, GA 30265
Mailing Address1615 Highway 34 E Ste BNewnan, GA 30265-1325 · (770) 400-8400 · Fax (770) 400-8401
Phone(770) 400-8400
Fax(770) 400-8401
Organization SubpartNo
Authorized OfficialDaivid Thomas HarveyPhysician · (770) 400-8400
Enumeration DateMarch 25, 2013
Last NPPES UpdateAugust 14, 2019
✔ NPI 1396087680 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.
1615 HIGHWAY 34 E STE B, Newnan, GA 30265
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Secondary Practice Locations 2

Location 160 Oak Hill Blvd, Suite 201Newnan, GA 30265-2314 · Phone (770) 400-8400 · Fax (770) 400-8401
Location 21075 Lafayette Pkwy Ste 240LaGrange, GA 30241-3734 · Phone (770) 400-8400 · Fax (770) 400-8401

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Surgical & Cosmetic Dermatology, P. C. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Surgical & Cosmetic Dermatology, P. C., which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

David Harvey, MD
Dermatology
NPI 1578526232
1615 HIGHWAY 34 E STE B
Newnan, GA 30265
(770) 400-8400
✔ PECOS✔ Accepts Medicare0.7 mi
Jessica Beattie, N.P.
Nurse Practitioner
NPI 1811448970
60 OAK HILL BLVD SUITE 201
Newnan, GA 30265
(770) 400-8400
✔ PECOS✔ Accepts Medicare0.9 mi
Jamie Raisor, ARNP
Nurse Practitioner
NPI 1235392424
1075 LAFAYETTE PKWY STE 240
Lagrange, GA 30241
(770) 400-8400
✔ PECOS✔ Accepts Medicare30 mi

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 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 11D2059751

Surgical & Cosmetic Dermatology, PC · Lagrange, GA
Active · expires Nov 14, 2027
CLIA Number11D2059751
Laboratory TypePhysician Office
Certificate Effective DateNovember 15, 2025
Certificate Expiration DateNovember 14, 2027
Laboratory DirectorDavid T. Harvey
Laboratory Phone(770) 400-8400
Laboratory LocationSurgical & Cosmetic Dermatology, PC1075 Lafayette Parkway, Suite 240, Lagrange, GA 30241
CLIA data matches this NPI record on: Address 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 11D2059065

Surgical & Cosmetic Dermatology · Newnan, GA
Active · expires Jan 15, 2027
CLIA Number11D2059065
Laboratory TypePhysician Office
Certificate Effective DateJanuary 16, 2025
Certificate Expiration DateJanuary 15, 2027
Laboratory DirectorDavid T. Harvey
Laboratory Phone(770) 400-8400
Laboratory LocationSurgical & Cosmetic Dermatology1615 Highway 34 East, Suite B, Newnan, GA 30265
CLIA data matches this NPI record on: Address 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.

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 Surgical & Cosmetic Dermatology, P. C.'s NPI number?

The NPI number for Surgical & Cosmetic Dermatology, P. C. is 1396087680. It was assigned to this organization in the NPPES registry on March 25, 2013.

Where is Surgical & Cosmetic Dermatology, P. C. located?

Surgical & Cosmetic Dermatology, P. C. is located at 1615 Highway 34 E Ste B, Newnan, GA 30265. The listed phone number is (770) 400-8400.

What is Surgical & Cosmetic Dermatology, P. C.'s specialty?

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

Is Surgical & Cosmetic Dermatology, P. C. enrolled in Medicare?

Yes. Surgical & Cosmetic Dermatology, P. C. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Surgical & Cosmetic Dermatology, P. C.?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Surgical & Cosmetic Dermatology, P. C., in Dermatology and Nurse Practitioner. 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 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Surgical & Cosmetic Dermatology, P. C. 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.

When was this NPI record last updated?

The NPPES record for Surgical & Cosmetic Dermatology, P. C. was last updated on August 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.