Dermatology of Southern Kentucky PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

39921 Issued in KY

Legal business name

DERMATOLOGY OF SOUTHERN KENTUCKY PLLC

Practice address

85 Tower Cir
Somerset, KY 42503-3476

Phone

(606) 772-3376

Fax

(606) 677-0335

NPI assigned

Jul 21, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Brian L Baker, MDNPI 1912128307

Title

Physician/Owner

Phone

(606) 772-3376

Specialties & licenses 4

Addresses

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 4

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.

• Brian L Baker, M.D.

  • MOHS-Micrographic Surgery Physician
  • Somerset, KY
  • NPI 1912128307

  Dermatology

  Medicare reassignment Care Compare group NPD Authorized official
• Jennifer A Baker, APRN

  • Family Nurse Practitioner
  • Somerset, KY
  • NPI 1134172232
  Medicare reassignment Care Compare group NPD
• Alena Thomas, PA

  • Physician Assistant
  • Raleigh, NC
  • NPI 1972847978

  KY

  Medicare reassignment Care Compare group NPD
• Kathryn Lauren Hayes, APRN

  • Family Nurse Practitioner
  • Lexington, KY
  • NPI 1831854934
  Medicare reassignment NPD

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332892800000",
    "number": "1326203142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 TOWER CIR",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033476",
            "telephone_number": "606-772-3376",
            "fax_number": "606-677-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 TOWER CIR",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033476",
            "telephone_number": "606-772-3376",
            "fax_number": "606-677-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY OF SOUTHERN KENTUCKY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-21",
        "last_updated": "2012-03-28",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "606-772-3376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "KY",
            "license": "39921",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "KY",
            "license": "39921",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1591",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "5583P",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Demunbrun, PT, DPT
• Steven M. Demunbrun, M.D.
• Travis Hamilton Denna, MD
• Doug Denney, RPH
• Dermatology Center of Lake Cumberland, PSC
• Sean Desimone, DO
• Christina Devlin
• Chasity Dezarn
• Alice Diaz, LPCA
• Amanda Carol Dick, CSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.