VLATKA AGNETTA, M.D. — NPI 1053602128 (Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist) in CHATTANOOGA, TN)

CMS-1500 Box 24J / 33a • NPI

1053602128

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

207ND0101X (CMS 07)

Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist)

Box 32 Service Location & ZIP+4

2358 LIFESTYLE WAY STE 212, CHATTANOOGA, TN, 37421-4904

✓ 9-Digit EDI 837 ZIP+4 (37421-4904)

Practice Phone & Referral Fax

(423) 521-1100

Fax: (423) 521-1200

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1053602128 (VLATKA AGNETTA, M.D.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1053602128` (NPI-1 Individual Practitioner)
Provider / Legal Name	VLATKA AGNETTA, M.D.
Plain-English Specialty	Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist) NUCC Code: `207ND0101X` (Dermatology, MOHS-Micrographic Surgery)
Certifying / Licensing Body	American Board of Dermatology (ABD)
Practice Location Address	2358 LIFESTYLE WAY STE 212, CHATTANOOGA, TN, 37421-4904
Practice Telephone / Fax	Tel: (423) 521-1100 \| Fax: (423) 521-1200
Administrative Mailing Address	136 BATTLEFIELD CROSSING CT, RINGGOLD, GA, 30736-5176
Enumeration & Last Sync	Enumerated: 2011-04-25 \| CMS Record Updated: 2021-01-19

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

2358 LIFESTYLE WAY STE 212, CHATTANOOGA, TN, 37421-4904

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Plain-English Taxonomy & CMS Crosswalk (207ND0101X)

What Does Taxonomy Code 207ND0101X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207ND0101X translates to:
"Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 07 (Physician/Dermatology) • CMS Code D7 (Micrographic Dermatologic Surgery)
Certifying / Accrediting Authority: American Board of Dermatology (ABD)
Clinical Scope: Changing moles, skin rashes, severe acne, eczema, psoriasis, fungal infections, hair loss, or skin cancer checks.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (VLATKA AGNETTA, M.D.)

Typical CPT / Diagnostic Procedures:

Full-Body Dermoscopy & Skin Cancer Screening
Shave, Punch & Excisional Skin Biopsy (CPT 11102–11107)
Cryotherapy Destruction of Actinic Keratoses & Viral Warts (CPT 17000)

Common Therapeutic Classes:

Topical Corticosteroids (Triamcinolone, Clobetasol) & Calcineurin Inhibitors
Topical & Oral Retinoids (Tretinoin, Adapalene, Isotretinoin)
Doxycycline, Minocycline & Antifungals (Terbinafine, Ketoconazole)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`207N00000X` — Dermatology Plain English: Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist)	State: GA \| License: `86364` \| Primary: Secondary
`207N00000X` — Dermatology Plain English: Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist)	State: CA \| License: `A122120` \| Primary: Secondary
`207N00000X` — Dermatology Plain English: Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist)	State: FL \| License: `ME140586` \| Primary: Secondary
`207N00000X` — Dermatology Plain English: Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist)	State: TN \| License: `61320` \| Primary: Secondary
`207P00000X` — Emergency Medicine Plain English: Board-Certified Emergency Medicine Physician (ER / Trauma Doctor)	State: CA \| License: `A122120` \| Primary: Secondary
`207ND0101X` — Dermatology, MOHS-Micrographic Surgery Plain English: Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist)	State: TN \| License: `61320` \| Primary: Yes (Primary)

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VLATKA AGNETTA, M.D. (NPI #1053602128)