Dermatology Specialists, PSC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY SPECIALISTS, PSC

Practice address

501 S 2ND St
First Floor
Louisville, KY 40202-2862

Phone

(502) 583-7546

Fax

(502) 589-3429

NPI assigned

Jan 17, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

J. Mark Jackson, M.D.

Title

Partner

Phone

(502) 583-7546

Specialties & licenses 2

Addresses

Other identifiers 4

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lindsay Chaput, APRN

  • Family Nurse Practitioner
  • Louisville, KY
  • NPI 1891042073
  NPD (past)
• Ashley C Cavalier, MD

  • Dermatology Physician
  • St Simons Island, GA
  • NPI 1558366534

  Specialist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389916800000",
    "number": "1013069301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S 2ND ST",
            "address_2": "FIRST FLOOR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022862",
            "telephone_number": "502-583-7546",
            "fax_number": "502-589-3429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S 2ND ST",
            "address_2": "FIRST FLOOR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402022862",
            "telephone_number": "502-583-7546",
            "fax_number": "502-589-3429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY SPECIALISTS, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2014-01-17",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "J.",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "502-583-7546",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRR MEDICARE",
            "identifier": "CA7485",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200044790B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "2433273000",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "1052384",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derby City Taxicab LLC
• Derbytown Healthcare LLC
• Brian M Derhake, M.D.
• Shannon Derkson
• Dermatology Associates , PSC
• Dermatopathology Alliance of Kentucky PLLC
• Dermatopathology Consultants of Kentucky PLLC
• Dermatran Health Solutions
• Dermcare Practitioners, LLC
• John W Derr Jr., M. D.

• Dermatology Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Dermatology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.