Central Kentucky Dermatology PLLC
NPI 1124741780 · Dermatology Physician · Nicholasville, KY
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Central Kentucky Dermatology PLLC is a Dermatology Physician organization in Nicholasville, KY (NPI 1124741780).
Provider details
- NPI number
- 1124741780
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Todd Clark, Medical Director(859) 608-9917
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Physician Assistant363A00000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2022-09-20
- Last updated
- 2025-07-10
- Certified
- 2025-07-10
Frequently asked questions
- What is Central Kentucky Dermatology PLLC's NPI number?
- Central Kentucky Dermatology PLLC's National Provider Identifier (NPI) is 1124741780, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Central Kentucky Dermatology PLLC?
- Central Kentucky Dermatology PLLC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Central Kentucky Dermatology PLLC located?
- Central Kentucky Dermatology PLLC's practice location on file with NPPES is 249 E Brannon Rd, Nicholasville, KY 40356-8059.
- What is Central Kentucky Dermatology PLLC's phone number?
- The practice phone number listed in the NPPES registry for Central Kentucky Dermatology PLLC is (859) 354-5455.
- Does Central Kentucky Dermatology PLLC accept Medicare?
- Central Kentucky Dermatology PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Central Kentucky Dermatology PLLC?
- The authorized official listed on Central Kentucky Dermatology PLLC's NPPES record is Todd Clark, Medical Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Central Kentucky Dermatology PLLC's NPI active?
- Yes — Central Kentucky Dermatology PLLC's NPI (1124741780) is active in the NPPES registry as of the last update on 2025-07-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.