Dermatopathology Alliance of Kentucky PLLC

Primary specialty

Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X

Legal business name

DERMATOPATHOLOGY ALLIANCE OF KENTUCKY PLLC

Practice address

839 S 2ND St
Louisville, KY 40203-2209

Phone

(502) 456-6217

Fax

(502) 456-4440

NPI assigned

Aug 15, 2006

Last updated

Feb 19, 2021By 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. Paul K Fearneyhough, MDNPI 1396858544

Title

Pathologist

Phone

(502) 583-5834

Specialties & licenses 4

Addresses

Other identifiers 20

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 2

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.

• Paul K Fearneyhough, M.D.

  • Dermatopathology (Pathology) Physician
  • Louisville, KY
  • NPI 1396858544
  Medicare reassignment NPD Authorized official
• George B Sonnier, M.D.

  • Dermatology Physician
  • Louisville, KY
  • NPI 1861495046
  Medicare reassignment NPD

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613692800000",
    "number": "1548273733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 BISHOP LN STE 1018",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402181928",
            "telephone_number": "502-456-6217",
            "fax_number": "502-456-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 S 2ND ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402032209",
            "telephone_number": "502-456-6217",
            "fax_number": "502-456-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOPATHOLOGY ALLIANCE OF KENTUCKY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A",
        "authorized_official_last_name": "FEARNEYHOUGH",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PATHOLOGIST",
        "authorized_official_telephone_number": "502-583-5834",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3103049",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "690009345",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS MD",
            "identifier": "BP87-0001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM MA",
            "identifier": "01895510",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2676260",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT LABOR  DEEOIC",
            "identifier": "611948800",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS MC SUPP",
            "identifier": "277243",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5115678",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100173900",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4409994",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "151583XX",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200364970A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT LABOR  BLACK LUNG",
            "identifier": "611948801",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6701094-000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "30004761050",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50115665",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BS",
            "identifier": "000000247638",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000100269",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA BETTER HEALTH",
            "identifier": "78469",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "93434",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Derbytown Healthcare LLC
• Brian M Derhake, M.D.
• Shannon Derkson
• Dermatology Associates , PSC
• Dermatology Specialists, PSC
• Dermatopathology Consultants of Kentucky PLLC (Family Dermatology)
• Dermatran Health Solutions
• Dermcare Practitioners, LLC
• John W Derr Jr., M. D.
• Ann M Derrick, APRN

• Dermatopathology (Pathology) Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Dermatopathology (Pathology) Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; 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.