NPIMap

Organization Active NPI

Northern Kentucky Dermatology PSC

  • Dermatology Physician
  • Crestview Hills, KY
National Provider Identifier
1528254992
Registry record updated Sep 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
27789 Issued in KY
Legal business name
NORTHERN KENTUCKY DERMATOLOGY PSC
Practice address
2701 Chancellor Dr
Crestview Hills, KY 41017-5479
Phone
(859) 341-1878
Fax
(859) 341-0560
NPI assigned
Sep 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2010

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

Authorized official

Name
Dr. William B Hoppenjans, M.D.
Title
President
Phone
(859) 341-1878

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X 27789 KY Primary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X 35.057303 OH
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X 31407 KY
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X 31407 KY

Addresses

Primary practice location

2701 Chancellor Dr
Crestview Hills, KY 41017-5479

Mailing address

2701 Chancellor Dr
Crestview Hills, KY 41017-5479
Phone (859) 341-1878

Other identifiers 1

IdentifierTypeStateIssuer
DB1814OtherRR MEDICARE

National Provider Directory

National Provider Directory

Locations

375 Thomas More Pkwy
Ste 102
Crestview Hills, KY 41017
Phone (606) 341-1878

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284681600000",
    "number": "1528254992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 CHANCELLOR DR",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410175479",
            "telephone_number": "859-341-1878",
            "fax_number": "859-341-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 CHANCELLOR DR",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410175479",
            "telephone_number": "859-341-1878",
            "fax_number": "859-341-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN KENTUCKY DERMATOLOGY PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2010-09-17",
        "status": "A",
        "authorized_official_last_name": "HOPPENJANS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-341-1878",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "KY",
            "license": "27789",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "OH",
            "license": "35.057303",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "KY",
            "license": "31407",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "KY",
            "license": "31407",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DB1814",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview Hills, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2010; 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.