COMMONWEALTH COMMUNITY CARE CENTERS, LLC (NPI# 1568094670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1568094670 |
Entity Type | Organization |
Organization Name | COMMONWEALTH COMMUNITY CARE CENTERS, LLC |
Practice Address |
156 North Lake Drive Prestonburg KY 41653 |
Practice Telephone | 6065065093 |
Practice Fax Number | 6065065039 |
Mailing Telephone | 6065065093 |
Mailing Fax Number | 6065065039 |
Enumeration Date | 2020-02-06 |
Last Update Date | 2020-07-21 |
Authorized Official Name | MRS. YVETTE WISENER (BILLING) |
Authorized Official Telephone | 2569643278 |
Authorized Official Credential | CPC |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
Allopathic & Osteopathic Physicians |
Street Address |
156 NORTH LAKE DRIVE |
City | PRESTONBURG |
State | KY |
Zip Code | 41653 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336781152 | Toni Coleman | Counselor | 104 South Front Ave, Prestonsburg, KY 41653 | 2019-10-14 |
1063070043 | Beverly Jane Daniel | Nurse Practitioner | 5230-ky-321#8, Prestonsburg, KY 41653 | 2019-06-04 |
1760966519 | Mackenzie Alvarez | Counselor | 104 South Front Avenue, Prestonsburg, KY 41653 | 2018-09-18 |
1427409739 | Css Rehab Services | Early Intervention Provider Agency | 165 Ridgewood Drive, Prestonsburg, KY 41653 | 2016-06-28 |
1356745509 | Rosanna Mccoy | Counselor | 105 Trimble Chapel Square, Prestonsburg, KY 41653 | 2014-10-17 |
1770828766 | Mary Whitney Amburgey | Physical Therapist | 5000 Ky-321, Prestonsburg, KY 41653 | 2012-12-03 |
1750648168 | Cynthia Crase | Social Worker | 311 N Arnold Ave Ste 504, Prestonsburg, KY 41653 | 2012-04-23 |
1003107566 | Shane Hensley | Pharmacist | 152 Collins Circle, Prestonsburg, KY 41653 | 2011-05-02 |
1659607018 | Paul Michael Burchett | Pharmacist | 5291 Ky Rte 321, Prestonsburg, KY 41653 | 2009-10-20 |
1285898064 | Minix One Hour Optical | Technician/Technologist | 212 Glenview Plaza, Prestonsburg, KY 41653 | 2008-07-11 |
Find all providers in zip 41653 |
Taxonomy Code | 207NS0135X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
Specialization | Procedural Dermatology |
Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629524913 | Forefront Dermatology, S.c. | Dermatology | 159 S. English Station Road, Louisville, KY 40245 | 2016-08-28 |
1841660305 | Forefront Dermatology, S.c. | Dermatology | 105 Medical Park Dr Ste 1, Campbellsville, KY 42718 | 2015-09-28 |
1871567578 | Michelle Deann Smith | Dermatology | 227 Burley Ave, Hopkinsville, KY 42240-8725 | 2006-02-17 |
1801893730 | Stuart Tobin | Dermatology | 740 S. Limestone, Rm L119, University of Kentucky, Ky Clinic, Lexington, KY 40536-0284 | 2005-07-07 |
1598135055 | Forefront Dermatology, S.c. | Dermatology | 100 Commerce Dr, C/o Brandenburg Diagnostic Center, Brandenburg, KY 40108 | 2015-09-28 |
1235343419 | Pikeville Dermatology & Cosmetic Center, Psc | Dermatology | 108 N Auxier Ave, Pikeville, KY 41501-9045 | 2007-05-09 |
1669426003 | Timothy R Lavender | Dermatology | 108 N Auxier Ave, Pikeville, KY 41501-9045 | 2006-05-20 |
City | PRESTONBURG |
Zip Code | 41653 |
Please comment or provide details below to improve the information on COMMONWEALTH COMMUNITY CARE CENTERS, LLC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.