Organization Active NPI

Valley Skin Specialists Kentucky PL LC

  • Dermatology Physician
  • Lexington, KY
National Provider Identifier
1093696734
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
VALLEY SKIN SPECIALISTS KENTUCKY PL LC
Practice address
2424 Sir Barton Way Ste 125
Lexington, KY 40509-2522
Phone
(859) 203-6990
Fax
(859) 203-6991
NPI assigned
Sep 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Authorized official

Name
Chad Johnston, DONPI 1962441212
Title
Owner
Phone
(540) 951-3376

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

2424 Sir Barton Way Ste 125
Lexington, KY 40509-2522

Mailing address

2424 Sir Barton Way Ste 125
Lexington, KY 40509-2522
Phone (859) 203-6990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260107000933 KY Part B Supplier - Clinic/Group Practice 1153817440 Receives reassigned benefits from 1 practitioner
Practice locations: Lexington, KY

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2334477Valley Skin Specialists Kentucky PLLC Dba2424 Sir Barton Way Suite 125, Lexington, KY 40509Certificate of waiverNov 20, 2027

National Provider Directory

National Provider Directory

Locations

2424 Sir Barton Way
Ste 125
Lexington, KY 40509
Phone (540) 951-3376

2720 Old Rosebud Rd
Lexington, KY 40509

2424 Sir Barton Way
Ste 123
Lexington, KY 40509

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1757376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783382400000",
    "number": "1093696734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2424 SIR BARTON WAY STE 125",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092522",
            "telephone_number": "859-203-6990",
            "fax_number": "859-203-6991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2424 SIR BARTON WAY STE 125",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092522",
            "telephone_number": "859-203-6990",
            "fax_number": "859-203-6991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY SKIN SPECIALISTS KENTUCKY PL LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-09",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-951-3376",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2026; 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.