Dermatology Center of Lake Cumberland, PSC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY CENTER OF LAKE CUMBERLAND, PSC

Practice address

120 Tradepark Dr
Suite B
Somerset, KY 42503-3454

Phone

(606) 679-9292

Fax

(606) 679-9294

NPI assigned

Oct 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Teresa Bentley, M.D.

Title

Physician/Owner

Phone

(606) 679-9292

Specialties & licenses 5

Addresses

Other identifiers 3

Practitioners 1

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

• Kimberly Meyer, MSNARNP

  • Family Nurse Practitioner
  • Somerset, KY
  • NPI 1235315755
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362960000000",
    "number": "1477639243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 TRADEPARK DR",
            "address_2": "SUITE B",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033454",
            "telephone_number": "606-679-9292",
            "fax_number": "606-679-9294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 TRADEPARK DR",
            "address_2": "SUITE B",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033454",
            "telephone_number": "606-679-9292",
            "fax_number": "606-679-9294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY CENTER OF LAKE CUMBERLAND, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2013-03-11",
        "status": "A",
        "authorized_official_last_name": "BENTLEY",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "606-679-9292",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "KY",
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207NI0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000059419",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65922262",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTOGBARAILROAD MEDIC",
            "identifier": "CA3970",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Curtis Alan Deloach, L.C.S.W.
• Olivia Demunbrun, PT, DPT
• Steven M. Demunbrun, M.D.
• Travis Hamilton Denna, MD
• Doug Denney, RPH
• Dermatology of Southern Kentucky PLLC
• Sean Desimone, DO
• Christina Devlin
• Chasity Dezarn
• Alice Diaz, LPCA

• 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 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.