Dermatology and Skin Cancer Specialists, PSC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

DERMATOLOGY AND SKIN CANCER SPECIALISTS, PSC

Practice address

3213 Summit Square PL Ste 200
Lexington, KY 40509-2652

Phone

(859) 264-0557

NPI assigned

Jul 7, 2006

Last updated

Jun 3, 2024By 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

Johnathon C. Edge, MDNPI 1114969201

Title

Partner

Phone

(859) 264-0557

Specialties & licenses 1

Addresses

Other identifiers 1

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 6

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.

• Johnathon Curtis Edge, MD

  • MOHS-Micrographic Surgery Physician
  • Owensboro, KY
  • NPI 1114969201
  Medicare reassignment Care Compare group NPD Authorized official
• Jaime Gish, APRN

  • Family Nurse Practitioner
  • Owensboro, KY
  • NPI 1932598117
  Medicare reassignment Care Compare group NPD
• Micaela Benton, PA-C

  • Physician Assistant
  • Lexington, KY
  • NPI 1902551146
  Medicare reassignment Care Compare group
• Sarah Miller Dougherty, PA-C

  • Physician Assistant
  • Lexington, KY
  • NPI 1881036259
  Medicare reassignment Care Compare group
• Deborah K Phillips, MD

  • Dermatology Physician
  • Lexington, KY
  • NPI 1124002811
  Medicare reassignment NPD
• Courtney Comella Mitchell, PAC

  • Medical Physician Assistant
  • Lexington, KY
  • NPI 1164411302
  Medicare reassignment

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1932132768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 E PARRISH AVE",
            "address_2": "BLDG E SUITE 205",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031449",
            "telephone_number": "270-852-1645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3213 SUMMIT SQUARE PL STE 200",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092652",
            "telephone_number": "859-264-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY AND SKIN CANCER SPECIALISTS, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "EDGE",
        "authorized_official_first_name": "JOHNATHON",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "859-264-0557",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000489532",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle L. Derbin, P.A.-C.
• Harry Derderian, M.D.
• Cindy Michelle Derer, DMD
• Phillip Derifield, L,M.T,
• Irina Derkach, RD, LD
• Dermatology Associates of Kentucky PSC
• Dermatology Associates of Kentucky, PSC
• Dermatology Associates of Kentucky, PSC (Dermatopathology Reference Lab)
• Dermatology Consultants, PSC
• Hunter Marcel Derouck

• MOHS-Micrographic Surgery Physician in Lexington, KY
• Providers in Lexington, KY by specialty
• MOHS-Micrographic Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.