DERMATOLOGY SPECIALISTS OF AUGUSTA, INC
NPI 1558339275
Dermatology in Evans, GA

Active since March 09, 2006CLIA 11D1027055 · Certificate of Compliance
1203 TOWN PARK LN, EVANS, GA 30809(706) 650-7546(706) 922-9169 Get Directions Write a Review

NPPES record last updated: January 13, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 13, 2023, Jun 29, 2018 (2 updates tracked since 2018).

About Dermatology Specialists Of Augusta, Inc NPPES

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

DERMATOLOGY SPECIALISTS OF AUGUSTA, INC (NPI 1558339275) is a healthcare organization registered as a dermatology in Evans, Georgia and active in the NPI registry since March 2006. The organization holds a CLIA Certificate of Compliance certificate valid through April 16, 2028, maintains a secondary practice location in Augusta, and lists Lisa Brooks, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1558339275
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameDERMATOLOGY SPECIALISTS OF AUGUSTA, INC
Location Address1203 TOWN PARK LNEvans, GA 30809-3481
Mailing Address1306 Concourse Dr Ste 201Linthicum Heights, MD 21090-1033 · (813) 341-3259 · Fax (813) 341-3259
Fax(706) 922-9169
Organization SubpartNo
Authorized OfficialLisa BrooksCredentialing Manager · (727) 547-0607
Enumeration DateMarch 9, 2006
Last NPPES UpdateJanuary 13, 20232 updates tracked since enumeration
NPPES CertifiedJanuary 13, 2023
✔ NPI 1558339275 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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 · License 049686 (GA)
Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X
1203 TOWN PARK LN, Evans, GA 30809

Secondary Practice Location 1

Location 11248 Augusta West PkwyAugusta, GA 30909-1854 · Phone (706) 863-0500 · Fax (706) 855-5062

Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dermatology Specialists Of Augusta, Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Dermatology Specialists Of Augusta, Inc, which bills Medicare for the services they deliver. Of these, 3 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Micrographic Dermatologic Surgery (MDS)
NPI 1033187703
1203 TOWN PARK LN
Evans, GA 30809
(706) 650-7546
✔ PECOS✔ Accepts Medicare0.4 mi
Nurse Practitioner
NPI 1255020327
1248 AUGUSTA WEST PKWY
Augusta, GA 30909
(706) 863-0500
✔ PECOS✔ Accepts Medicare4.3 mi
Dermatology
NPI 1093219339
1248 AUGUSTA WEST PKWY
Augusta, GA 30909
(706) 863-0500
✔ PECOS✔ Accepts Medicare4.3 mi
Micrographic Dermatologic Surgery (MDS)
NPI 1023646064
3850 PLEASANT HILL RD
Duluth, GA 30096
(770) 814-8222
✔ PECOS✔ Accepts Medicare121 mi
Dermatology
NPI 1003808361
3850 PLEASANT HILL RD
Duluth, GA 30096
(770) 814-8222
✔ PECOS✔ Accepts Medicare121 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

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 11D1027055

Dermatology Specialists Of Augusta · Evans, GA
Active · expires Apr 16, 2028
CLIA Number11D1027055
Laboratory TypePhysician Office
Certificate Effective DateApril 17, 2026
Certificate Expiration DateApril 16, 2028
Laboratory DirectorBrandon W. Burroway
Laboratory Phone(706) 650-7546
Laboratory LocationDermatology Specialists Of Augusta1203 Town Park Lane, Evans, GA 30809
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 Dermatology Specialists Of Augusta, Inc's NPI number?

The NPI number for Dermatology Specialists Of Augusta, Inc is 1558339275. It was assigned to this organization in the NPPES registry on March 9, 2006.

Where is Dermatology Specialists Of Augusta, Inc located?

Dermatology Specialists Of Augusta, Inc is located at 1203 Town Park Ln, Evans, GA 30809. The listed phone number is (706) 650-7546.

What is Dermatology Specialists Of Augusta, Inc's specialty?

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

Is Dermatology Specialists Of Augusta, Inc enrolled in Medicare?

Yes. Dermatology Specialists Of Augusta, Inc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Dermatology Specialists Of Augusta, Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians reassign their Medicare billing to Dermatology Specialists Of Augusta, Inc, in Dermatology, Micrographic Dermatologic Surgery (MDS) 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, 3 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Dermatology Specialists Of Augusta, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 11D1027055) is associated with this NPI, valid through April 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Dermatology Specialists Of Augusta, Inc 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 Dermatology Specialists Of Augusta, Inc 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 Dermatology Specialists Of Augusta, Inc was last updated on January 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.