Active NPI
Dermatology Associates of Kentucky, PSC
- Clinical Medical Laboratory
- Lexington, KY
National Provider Identifier
1831231745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 200197
- Legal business name
- DERMATOLOGY ASSOCIATES OF KENTUCKY, PSC
- Doing business as
- Dermatopathology Reference Lab
- Practice address
- 250 Fountain CT
Lexington, KY 40509-1888 - Phone
- (859) 263-4444
- Fax
- (859) 543-8867
- NPI assigned
- Feb 14, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Fernando De Castro, M.D.
- Title
- Medical Director
- Phone
- (859) 263-4444
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 200197 | KY | Primary |
Addresses
Primary practice location
250 Fountain CT
Lexington, KY 40509-1888
Mailing address
250 Fountain CT
Lexington, KY 40509-1888
Phone (859) 263-4444
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0350069 | Other | KY | UNITED HEALTHCARE |
| 37000163 | Medicaid | KY | |
| C03011 | Other | CUMBERLAND HEALTHCARE | |
| 000000179530 | Other | KY | ANTHEM BLUE CROSS & BLUE SHIELD |
Other names 1
- Dermatopathology Reference Lab
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1659398400000",
"number": "1831231745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 FOUNTAIN CT",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405091888",
"telephone_number": "859-263-4444",
"fax_number": "859-543-8867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 FOUNTAIN CT",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405091888",
"telephone_number": "859-263-4444",
"fax_number": "859-543-8867"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DERMATOLOGY ASSOCIATES OF KENTUCKY, PSC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-14",
"last_updated": "2022-08-02",
"certification_date": "2022-08-02",
"status": "A",
"authorized_official_last_name": "DE CASTRO",
"authorized_official_first_name": "FERNANDO",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "859-263-4444",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "KY",
"license": "200197",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0350069",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "37000163",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CUMBERLAND HEALTHCARE",
"identifier": "C03011",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS & BLUE SHIELD",
"identifier": "000000179530",
"state": "KY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Dermatopathology Reference Lab",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.