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SOUTHERN DERMATOLOGY PC
NPI 1437437837
Dermatology in Lawrenceville, GA

Active since August 02, 2011
1805 HERRINGTON RD, BUILDING 3, SUITE A, LAWRENCEVILLE, GA 30043(770) 817-2592(678) 377-8167 Get Directions Write a Review

NPPES record last updated: September 28, 2011. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Southern Dermatology Pc NPPES

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

SOUTHERN DERMATOLOGY PC (NPI 1437437837) is a healthcare organization registered as a dermatology in Lawrenceville, Georgia and active in the NPI registry since August 2011. The organization lists Winfred Derrick Moody, Owner, as its authorized official.

NPPES Registry Identity

NPI1437437837
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSOUTHERN DERMATOLOGY PC
Location Address1805 HERRINGTON RD, BUILDING 3, SUITE ALawrenceville, GA 30043-7987
Mailing Address1805 Herrington Rd, Building 3, Suite ALawrenceville, GA 30043-7987 · (770) 817-2592 · Fax (678) 377-8167
Phone(770) 817-2592
Fax(678) 377-8167
Organization SubpartNo
Authorized OfficialWinfred Derrick MoodyOwner · (770) 817-2592
Enumeration DateAugust 2, 2011
Last NPPES UpdateSeptember 28, 2011
✔ NPI 1437437837 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in GA · 045299
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.
1805 HERRINGTON RD, Lawrenceville, GA 30043
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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 ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southern Dermatology Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Southern Dermatology PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Winfred Moody, MD
Dermatology
NPI 1124000187
565 OLD NORCROSS RD SUITE #200
Lawrenceville, GA 30046
(770) 962-5040
✔ PECOS✔ Accepts Medicare4.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Southern Dermatology PC's NPI number?

The NPI number for Southern Dermatology PC is 1437437837. It was assigned to this organization in the NPPES registry on August 2, 2011.

Where is Southern Dermatology PC located?

Southern Dermatology PC is located at 1805 Herrington Rd Building 3, Suite A, Lawrenceville, GA 30043. The listed phone number is (770) 817-2592.

What is Southern Dermatology PC's specialty?

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

Is Southern Dermatology PC enrolled in Medicare?

Yes. Southern Dermatology PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Southern Dermatology PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Southern Dermatology PC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Southern Dermatology PC accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Southern Dermatology 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 Southern Dermatology PC was last updated on September 28, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.