Individual provider Active NPI

Madelyn Farrell Oliver Jeter, MD

  • Dermatology Physician
  • Lexington, KY
National Provider Identifier
1891228425
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
57912 Issued in KY
Practice address
250 Fountain CT
Lexington, KY 40509-1888
Phone
(859) 263-4444
NPI assigned
Apr 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 57912 KY Primary

Addresses

Primary practice location

250 Fountain CT
Lexington, KY 40509-1888

Mailing address

1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230706002399 KY Practitioner - Dermatology 4587081609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Louisville School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Lexington Clinic PSCGroup PAC ID 3476457532, 329 clinicians

Practice addresses (Care Compare)

108 Diagnostic Dr
Suite a
Frankfort, KY 40601-6556
Phone (859) 263-4444

1207 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-4000

1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-4000

1225 S Broadway
Suite 201
Lexington, KY 40504-2701
Phone (859) 258-4568

250 Fountain CT
Lexington, KY 40509-1888
Phone (859) 263-4444

611 Tighlman Way
Suite B
Mt Sterling, KY 40353-1755
Phone (859) 263-4444

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions794
Removal or shaving of skin growth82
Skin biopsy187

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57912KYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New Lexington Clinic PSC CurrentSince Nov 1, 2023 Accepting new patients
New Lexington Clinic, PSC CurrentSince Nov 1, 2023 Accepting new patients

Locations

108 Diagnostic Dr
Ste A
Frankfort, KY 40601
Phone (502) 226-5360

1221 S Broadway
Lexington, KY 40504
Phone (859) 258-4181

250 Fountain Ct
Lexington, KY 40509
Phone (859) 263-4444

Interoperability endpoints

  • Direct secure messaging: madelyn.jeter.1@13059.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1891228425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-6200",
            "fax_number": "859-258-6203"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETER",
        "first_name": "MADELYN",
        "middle_name": "FARRELL OLIVER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "57912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.