NPIMap

Organization Active NPI

Associates in Dermatology, PLLC

  • Dermatology Physician
  • Louisville, KY
National Provider Identifier
1629083399
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ASSOCIATES IN DERMATOLOGY, PLLC
Practice address
3810 Springhurst Blvd
Suite 200
Louisville, KY 40241
Phone
(502) 583-1749
Fax
(502) 329-8184
NPI assigned
Jul 30, 2006
Last updated
Jul 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Authorized official

Name
Jyoti Burruss, MDNPI 1003821810
Title
Partner
Phone
(502) 583-1749

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Nurse Practitioner 363L00000X NU
Dermatology Physician 207N00000X NU Primary
Dermatopathology Physician 207ND0900X NU

Addresses

Primary practice location

3810 Springhurst Blvd
Suite 200
Louisville, KY 40241

Mailing address

3810 Springhurst Blvd
Suite 200
Louisville, KY 40241-6100
Phone (502) 583-1749

Other practice location 1

10302 Brookridge Village Blvd Ste 102
Louisville, KY 40291-4475
Phone (502) 583-1749

Other practice location 2

2241 Green Valley Rd
New Albany, IN 47150-4647
Phone (502) 583-1749

Other practice location 3

908 Wallace Ave Ste 203
Leitchfield, KY 42754-1495
Phone (502) 583-1749

Other practice location 4

3 Audubon Plaza Dr Ste 630
Louisville, KY 40217-1362
Phone (502) 583-1749

Other practice location 5

130 Stonecrest Rd Ste 104
Shelbyville, KY 40065-8126
Phone (502) 583-1749

Other practice location 6

325 W Walnut St Ste 300
Lebanon, KY 40033-1381
Phone (502) 583-1749

Other practice location 7

1005 E Lewis and Clark Pkwy
Clarksville, IN 47129-2201
Phone (502) 583-1749

Other practice location 8

114 Manor Ave Ste 3
Bardstown, KY 40004-3231
Phone (502) 583-1749

Other practice location 9

1028 N Dixie Ave Ste 140
Elizabethtown, KY 42701-2508
Phone (502) 583-1749

Other identifiers 4

IdentifierTypeStateIssuer
000000059426OtherKYANTHEM
100010640AMedicaidIN
65912032MedicaidKY
7100295380MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040325000047 KY Part B Supplier - Clinic/Group Practice 1658263876 Receives reassigned benefits from 44 practitioners
Practice locations: Louisville, KY; Shelbyville, KY; Lebanon, KY; Leitchfield, KY; Bardstown, KY; Elizabethtown, KY; Campbellsville, KY
O20101208001084 IN Part B Supplier - Clinic/Group Practice 1658263876 Receives reassigned benefits from 16 practitioners
Practice locations: New Albany, IN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D1046062Associates in Dermatology, PLLC2241 Green Valley Road, New Albany, IN 47150ComplianceJan 12, 2027
15D2186531Associates in Dermatology1005 E Lewis and Clark Parkway Spectrum, Clarksville, IN 47129Provider-performed microscopyJun 17, 2028
18D0682078Associates in Dermatology3810 Springhurst Boulevard, Ste LL, Louisville, KY 40241AccreditationDec 7, 2026
18D2048327Associates in Dermatology, PLLC3810 Springhurst Blvd #200, Louisville, KY 40241ComplianceJan 22, 2027
18D2117519Associates in Dermatology, PLLC325 West Walnut Street, Suite 300, Lebanon, KY 40033Provider-performed microscopyAug 17, 2026
18D2122310Associates in Dermatology, PLLC3 Audubon Plaza Suite 630, Louisville, KY 40217Provider-performed microscopyFeb 26, 2027
18D2156587Associates in Dermatology PLLC1028 N Dixie Ave, Ste 140, Elizabethtown, KY 42701ComplianceApr 10, 2027

National Provider Directory

National Provider Directory

Locations

2241 Green Valley Rd
New Albany, IN 47150
Phone (812) 948-1148

114 Manor Ave
Ste 3
Bardstown, KY 40004

700 Portland Ave
Ste B
Bardstown, KY 40004
Phone (270) 234-6695

1028 N Dixie Ave
Ste 102
Elizabethtown, KY 42701

1028 N Dixie Ave
Ste 140
Elizabethtown, KY 42701

320 N Loretto Rd
#500
Lebanon, KY 40033
Phone (270) 692-2098

506 S Main St
Leitchfield, KY 42754
Phone (270) 200-1095

3 Audubon Plaza Dr
Ste 630
Louisville, KY 40217
Phone (502) 326-8588

3810 Springhurst Blvd
Ste 200
Louisville, KY 40241

Practitioners & affiliated clinicians

Practitioners 82

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.

View all 82

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594771200000",
    "number": "1629083399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 SPRINGHURST BLVD",
            "address_2": "SUITE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402416100",
            "telephone_number": "502-583-1749",
            "fax_number": "502-329-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 SPRINGHURST BLVD",
            "address_2": "SUITE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40241",
            "telephone_number": "502-583-1749",
            "fax_number": "502-329-8184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10302 Brookridge Village Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402914475",
            "country_code": "US",
            "telephone_number": "502-583-1749",
            "fax_number": "502-329-8184",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2241 Green Valley Rd",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "IN",
            "postal_code": "471504647",
            "country_code": "US",
            "telephone_number": "502-583-1749",
            "fax_number": "502-329-8184",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "908 Wallace Ave Ste 203",
            "address_purpose": "LOCATION",
            "city": "Leitchfield",
            "state": "KY",
            "postal_code": "427541495",
            "country_code": "US",
            "telephone_number": "502-583-1749",
            "fax_number": "502-329-8184",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 Audubon Plaza Dr Ste 630",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402171362",
            "country_code": "US",
            "telephone_number": "502-583-1749",
            "fax_number": "502-329-8184",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 Stonecrest Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Shelbyville",
            "state": "KY",
            "postal_code": "400658126",
            "country_code": "US",
            "telephone_number": "502-583-1749",
            "fax_number": "502-329-8184",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 W Walnut St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "KY",
            "postal_code": "400331381",
            "country_code": "US",
            "telephone_number": "502-583-1749",
            "fax_number": "502-329-8184",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1005 E Lewis and Clark Pkwy",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "IN",
            "postal_code": "471292201",
            "country_code": "US",
            "telephone_number": "502-583-1749",
            "fax_number": "502-329-8184",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "114 Manor Ave Ste 3",
            "address_purpose": "LOCATION",
            "city": "Bardstown",
            "state": "KY",
            "postal_code": "400043231",
            "country_code": "US",
            "telephone_number": "502-583-1749",
            "fax_number": "502-329-8184",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1028 N Dixie Ave Ste 140",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "KY",
            "postal_code": "427012508",
            "country_code": "US",
            "telephone_number": "502-583-1749",
            "fax_number": "502-329-8184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ASSOCIATES IN DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A",
        "authorized_official_last_name": "BURRUSS",
        "authorized_official_first_name": "JYOTI",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "502-583-1749",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000059426",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100010640A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65912032",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100295380",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.