Central Kentucky Dermatology PLLC
NPI 1124741780ActiveOrganization· Dermatology· Nicholasville, KY
Dermatology in Nicholasville, Kentucky, registered in NPPES in September 2022. The authorized official on file is Todd Clark, MD, Medical Director. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1124741780 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 20, 2022 |
| Last updated in NPPES | Jul 10, 2025 |
| Certified by provider | Jul 10, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
| Physician Assistant | 363A00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (KY) |
|---|
Other Dermatology providers in Nicholasville
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