Organization Active NPI

King'S Daughters Medical Specialties, Inc.

  • Dermatology Physician
  • Ashland, KY
National Provider Identifier
1265063580
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
KING'S DAUGHTERS MEDICAL SPECIALTIES, INC.
Practice address
2930 Carter Ave
Ashland, KY 41101-1943
Phone
(606) 324-1483
Fax
(606) 329-2612
NPI assigned
Jan 27, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Authorized official

Name
Sara Marks
Title
Ceo
Phone
(606) 408-4401

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X Primary
Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

2930 Carter Ave
Ashland, KY 41101-1943

Mailing address

PO Box 2379
Ashland, KY 41105-2379
Phone (606) 408-6200

Other names 1

  • Kings Daughters Medical Specialties Dermatology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100114000813 OH Part B Supplier - Clinic/Group Practice 6103968029 Receives reassigned benefits from 181 practitioners
24 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wheelersburg, OH; Waverly, OH; South Point, OH; Portsmouth, OH; Lucasville, OH; Jackson, OH; Ironton, OH; Franklin Furance, OH
O20100217000538 KY Part B Supplier - Clinic/Group Practice 6103968029 Receives reassigned benefits from 554 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 33

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 33

National Provider Directory

National Provider Directory

Locations

1180 Saint Christopher Dr
#2
Ashland, KY 41101
Phone (606) 408-9565

100 Bellefonte Dr
Grayson, KY 41143
Phone (606) 474-0669

Practitioners & affiliated clinicians

Practitioners 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758499200000",
    "number": "1265063580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2379",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052379",
            "telephone_number": "606-408-6200",
            "fax_number": "606-408-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 CARTER AVE",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411011943",
            "telephone_number": "606-324-1483",
            "fax_number": "606-329-2612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING'S DAUGHTERS MEDICAL SPECIALTIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-27",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A",
        "authorized_official_last_name": "MARKS",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "606-408-4401"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kings Daughters Medical Specialties Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kings Daughters Medical Specialties Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ashland, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.