Dermatopathology Consultants of Kentucky PLLC

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

Legal business name

DERMATOPATHOLOGY CONSULTANTS OF KENTUCKY PLLC

Doing business as

Family Dermatology

Practice address

2307 Greene Way Ste a
Louisville, KY 40220-4097

Phone

(502) 806-3376

Fax

(502) 495-0156

NPI assigned

Feb 18, 2015

Last updated

Sep 20, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. TJ Burch

Title

Office Manager

Phone

(502) 495-1162

Specialties & licenses 4

Addresses

Other names 1

• Family Dermatology Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrea S Burch, M.D.

  • Dermatopathology Physician
  • Louisville, KY
  • NPI 1063482214
  Medicare reassignment NPD
• Heather J Mucci, ARNP

  • Nurse Practitioner
  • Louisville, KY
  • NPI 1518916329
  Medicare reassignment NPD
• Samantha A Sears, MD

  • Dermatology Physician
  • Cincinnati, OH
  • NPI 1700312352

  KY

  Medicare reassignment NPD
• Catherine Bickel Booker, PA-C

  • Physician Assistant
  • Prospect, KY
  • NPI 1316389927
  Medicare reassignment
• Robert Nicholas Cacchione, MD

  • Surgery Physician
  • Louisville, KY
  • NPI 1760462790
  NPD (past)

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

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726790400000",
    "number": "1023409612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 GREENE WAY STE C",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402204097",
            "telephone_number": "502-806-3376",
            "fax_number": "502-495-0156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 GREENE WAY STE A",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402204097",
            "telephone_number": "502-806-3376",
            "fax_number": "502-495-0156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOPATHOLOGY CONSULTANTS OF KENTUCKY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-18",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A",
        "authorized_official_last_name": "BURCH",
        "authorized_official_first_name": "TJ",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "502-495-1162",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brian M Derhake, M.D.
• Shannon Derkson
• Dermatology Associates , PSC
• Dermatology Specialists, PSC
• Dermatopathology Alliance of Kentucky PLLC
• Dermatran Health Solutions
• Dermcare Practitioners, LLC
• John W Derr Jr., M. D.
• Ann M Derrick, APRN
• Shannon Metcalf Derrick, LPCC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.