MARIETTA DERMATOLOGY ASSOCIATES PA
NPI 1417007212
Dermatology in Marietta, GA
About Marietta Dermatology Associates Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARIETTA DERMATOLOGY ASSOCIATES PA (NPI 1417007212) is a healthcare organization registered as a dermatology in Marietta, Georgia and active in the NPI registry since January 2007. The organization holds 2 active CLIA laboratory certificates and lists Kami Alford, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Marietta Dermatology Associates Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
15Medicare enrollment records show 15 clinicians reassign Medicare billing to Marietta Dermatology Associates PA, which bills Medicare for the services they deliver. Of these, 8 practice at this address and 10 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 3
Clinicians, nearest first (15)
Concord, NH 03301
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 for Provider-Performed Microscopy Procedures (PPMP) 11D0943797
Marietta Dermatology Associates PA · Canton, GACertificate for Provider-Performed Microscopy Procedures (PPMP) 11D0943798
Marietta Dermatology Associates PA · Powder Springs, 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 Marietta Dermatology Associates PA's NPI number?
The NPI number for Marietta Dermatology Associates PA is 1417007212. It was assigned to this organization in the NPPES registry on January 12, 2007.
Where is Marietta Dermatology Associates PA located?
Marietta Dermatology Associates PA is located at 111 Marble Mill Rd NW Marietta Dermatology Associates PA, Marietta, GA 30060. The listed phone number is (770) 422-1013.
What is Marietta Dermatology Associates PA's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Marietta Dermatology Associates PA enrolled in Medicare?
Yes. Marietta Dermatology Associates PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Marietta Dermatology Associates PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 15 clinicians in 3 Medicare specialties reassign their Medicare billing to Marietta Dermatology Associates PA. 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. The largest specialties are Dermatology (13), Micrographic Dermatologic Surgery (MDS) (1) and Plastic and Reconstructive Surgery (1). Of these, 8 practice at this address and 10 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Marietta Dermatology Associates PA 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 Marietta Dermatology Associates PA was last updated on September 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 41 days 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.
# Marietta Dermatology Associates Pa · NPI 1417007212
Dermatology organization in Marietta, Georgia. Organization record, active in the CMS NPPES registry since January 12, 2007.
## Identity
- **NPI:** 1417007212 (Entity type: Organization)
- **Enumerated:** January 12, 2007
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Kami Alford, CEO
## Practice location
- **Address:** 111 MARBLE MILL RD NW, MARIETTA DERMATOLOGY ASSOCIATES PA, Marietta, GA 30060-1047
- **Phone:** (770) 422-1013 · **Fax:** (770) 514-5996
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 15 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (13), Micrographic Dermatologic Surgery (MDS) (1), Plastic and Reconstructive Surgery (1); 8 practice at this address and 10 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 10, 2026
- **Other identifiers:** Other CM6753
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1417007212) · Data from the CMS NPPES public registry.