Todd V Clark, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

42806 Issued in KY

Practice address

249 E Brannon Rd
Nicholasville, KY 40356-8059

Phone

(859) 354-5455

Fax

(859) 203-8833

NPI assigned

Apr 1, 2009

Last updated

Jul 10, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Kentucky College of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Kentucky Dermatology PLLCGroup PAC ID 2860869351, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tclark@ckyderm.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Kentucky Dermatology PLLC

  • Dermatology Physician
  • Nicholasville, KY
  • NPI 1124741780
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1205078664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "249 E BRANNON RD",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403568059",
            "telephone_number": "859-354-5455",
            "fax_number": "859-203-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "249 E BRANNON RD",
            "city": "NICHOLASVILLE",
            "state": "KY",
            "postal_code": "403568059",
            "telephone_number": "859-354-5455",
            "fax_number": "859-203-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TODD",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-01",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "42806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS & BLUE SHIELD",
            "identifier": "000000612211",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paige T Christian, MSW, LCSW
• Christy McCoy, LLC
• Kerrie Anne Cieply, D.C.
• Heather Clark, APRN PMHNP-BC
• Thomas B Clark
• Clear View Recovery LLC (Clear View Behavioral Health)
• Katharine McDowell Clemmer, MD
• Benjamin Simms Cloyd
• Stephanie Michelle Cobb
• Rachael Coker

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.