CMS-1500 Box 24J / 33a • NPI
1841852076
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
207N00000X (CMS 07)
Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist)
Box 32 Service Location & ZIP+4
105 PROFESSIONAL PARK DR, CUMMING, GA, 30040-2381
✓ 9-Digit EDI 837 ZIP+4 (30040-2381)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1841852076 (CLEAVER MEDICAL GROUP DERMATOLOGY INC) 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
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1841852076 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | CLEAVER MEDICAL GROUP DERMATOLOGY INC |
| Plain-English Specialty | Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist) NUCC Code: 207N00000X (Dermatology) |
| Certifying / Licensing Body | American Board of Dermatology (ABD) |
| Practice Location Address | 105 PROFESSIONAL PARK DR, CUMMING, GA, 30040-2381 |
| Practice Telephone / Fax | Tel: (770) 800-3455 | Fax: (770) 284-8380 |
| Administrative Mailing Address | 59 TIPTON DR, DAHLONEGA, GA, 30533-1603 |
| Enumeration & Last Sync | Enumerated: 2019-07-09 | CMS Record Updated: 2025-12-02 |
| Authorized Official | ASHLEY DORSEY (Practice Administrator) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (207N00000X)
What Does Taxonomy Code 207N00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207N00000X translates to:
"Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (CLEAVER MEDICAL GROUP DERMATOLOGY INC)
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)
- 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 |
|---|---|
207ND0900X — Dermatology, DermatopathologyPlain English: Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist) | State: N/A | License: Verified | Primary: Secondary |
207ND0101X — Dermatology, MOHS-Micrographic SurgeryPlain English: Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist) | State: N/A | License: Verified | Primary: Secondary |
207N00000X — DermatologyPlain English: Board-Certified Dermatologist (Skin, Hair & Nail Medical/Surgical Specialist) | State: N/A | License: Verified | Primary: Yes (Primary) |
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