Pikeville Dermatology & Cosmetic Center, PSC

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

02627 Issued in KY

Legal business name

PIKEVILLE DERMATOLOGY & COSMETIC CENTER, PSC

Practice address

108 N Auxier Ave
Pikeville, KY 41501-9045

Phone

(606) 432-9106

Fax

(606) 432-0967

NPI assigned

May 9, 2007

Last updated

Jun 11, 2020By 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

Dr. Timothy R Lavender, D.O.NPI 1669426003

Title

Owner & Physician

Phone

(606) 432-9106

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

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

Interoperability endpoints

• Direct secure messaging: tlavender@directaddress.net

Practitioners 1

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.

• Timothy R Lavender, D.O.

  • Procedural Dermatology Physician
  • Pikeville, KY
  • NPI 1669426003
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1235343419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N AUXIER AVE",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415019045",
            "telephone_number": "606-432-9106",
            "fax_number": "606-432-0967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N AUXIER AVE",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415019045",
            "telephone_number": "606-432-9106",
            "fax_number": "606-432-0967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIKEVILLE DERMATOLOGY & COSMETIC CENTER, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "LAVENDER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER & PHYSICIAN",
        "authorized_official_telephone_number": "606-432-9106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "KY",
            "license": "02627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64005812",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010250030",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900011000",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tlavender@directaddress.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "XML",
            "address_1": "108 N Auxier Ave",
            "city": "Pikeville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "415019045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pike County Health Department-Dental
• Pike County Health Department-Pikeville Elementary School
• Pike County Health Department-Pikeville High School
• Pikeville Cardiology Clinic
• Pikeville Community Pharmacy
• Pikeville Family Medicine Associates
• Pikeville Foot Care Center PLLC
• Pikeville Independent School
• Pikeville Medical Building Lab., Inc.
• Pikeville Medical Center Inc

• Procedural Dermatology Physician in Pikeville, KY
• Providers in Pikeville, KY by specialty
• Procedural Dermatology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.