Paducah Dermatology Surgery Center PLLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PADUCAH DERMATOLOGY SURGERY CENTER PLLC

Practice address

127 Alben Barkley Drive Suite a
Paducah, KY 42001

Phone

(270) 444-8477

Fax

(270) 444-8479

NPI assigned

Sep 17, 2024

Organization subpart

No

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

Authorized official

Name

Erica Housman

Title

ASC Administrator

Phone

(270) 444-8477

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Ambulatory surgical center certification: CCN 18C0001062

Legal name

Paducah Dermatology Surgery Center PLLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Sep 4, 2025

Last certification

Sep 4, 2025

Facility address

127 Alben Barkley Drive, Suite A
Paducah, KY 42001

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 1

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

• Joseph Allen Blackmon, M.D.

  • MOHS-Micrographic Surgery Physician
  • Paducah, KY
  • NPI 1003133901
  Medicare reassignment

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

{
    "created_epoch": "1726531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765152000000",
    "number": "1689401465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 ALBEN BARKLEY DR STE A",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420014402",
            "telephone_number": "270-444-8477",
            "fax_number": "270-444-8479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 ALBEN BARKLEY DRIVE SUITE A",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "42001",
            "telephone_number": "270-444-8477",
            "fax_number": "270-444-8479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PADUCAH DERMATOLOGY SURGERY CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-17",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A",
        "authorized_official_last_name": "HOUSMAN",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "ASC ADMINISTRATOR",
        "authorized_official_telephone_number": "270-444-8477"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark L Owens, O.D.
• Paducah Area Physicisns, Inc
• Paducah Center for Health and Rehabilitation, LLC
• Paducah Chiropractic Center, PSC
• Paducah Dermatology PLLC
• Paducah Gastroenterology Associates, PSC
• Paducah Gastroenterology Associates, PSC
• Paducah Health Facilities LP
• Paducah Health Services, LLC
• Paducah Hearing Center Inc

• Ambulatory Surgical Clinic/Center in Paducah, KY
• Providers in Paducah, KY by specialty
• Ambulatory Surgical Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.