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DIVINE DERMATOLOGY & AESTHETICS LLC
NPI 1730682725
Dermatology in Atlanta, GA

Active since March 15, 2018CLIA 11D2149506 · Microscopy
1039 GRANT ST SE STE A-11, ATLANTA, GA 30315(678) 589-7546(678) 589-7500 Get Directions Write a Review

NPPES record last updated: March 15, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Divine Dermatology & Aesthetics Llc NPPES

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

DIVINE DERMATOLOGY & AESTHETICS LLC (NPI 1730682725) is a healthcare organization registered as a dermatology in Atlanta, Georgia and active in the NPI registry since March 2018. The organization holds a CLIA Microscopy certificate valid through June 4, 2028 and lists Tunisia F. Cornelius, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1730682725
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameDIVINE DERMATOLOGY & AESTHETICS LLC
Location Address1039 GRANT ST SE STE A-11Atlanta, GA 30315-2014
Mailing Address830 Glenwood Ave Se Ste 510-209Atlanta, GA 30316-1966 · (678) 589-7546 · Fax (678) 589-7500
Phone(678) 589-7546
Fax(678) 589-7500
Organization SubpartNo
Authorized OfficialTunisia F. CorneliusAuthorized Official · (678) 589-7546
Enumeration DateMarch 15, 2018
✔ NPI 1730682725 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
1039 GRANT ST SE STE A-11, Atlanta, GA 30315
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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 Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

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 for Provider-Performed Microscopy Procedures (PPMP) 11D2149506

Divine Dermatology & Aesthetics, LLC · Atlanta, GA
Active · expires Jun 4, 2028
CLIA Number11D2149506
Laboratory TypePhysician Office
Certificate Effective DateJune 5, 2026
Certificate Expiration DateJune 4, 2028
Laboratory DirectorTunisia F. Cornelius
Laboratory Phone(678) 589-7546
Laboratory LocationDivine Dermatology & Aesthetics, LLC1323 Metropolitan Parkway SW, Atlanta, GA 30310
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES

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

DR. TUNISIA FINCH CORNELIUS M.D.
Dermatology
1039 GRANT ST SE STE A-11
ATLANTA, GA 30315
Fulton County (678) 589-7546

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 Divine Dermatology & Aesthetics LLC's NPI number?

The NPI number for Divine Dermatology & Aesthetics LLC is 1730682725. It was assigned to this organization in the NPPES registry on March 15, 2018.

Where is Divine Dermatology & Aesthetics LLC located?

Divine Dermatology & Aesthetics LLC is located at 1039 Grant St SE Ste A-11, Atlanta, GA 30315. The listed phone number is (678) 589-7546.

What is Divine Dermatology & Aesthetics LLC's specialty?

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

Does Divine Dermatology & Aesthetics LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 11D2149506) is associated with this NPI, valid through June 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Divine Dermatology & Aesthetics LLC 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 Divine Dermatology & Aesthetics 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 Divine Dermatology & Aesthetics LLC was last updated on March 15, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.