1. Home
  2. Directory
  3. Kentucky
  4. Prestonsburg
  5. Dermatology
  6. NPI Profile

COMMONWEALTH COMMUNITY CARE CENTERS, LLC
NPI 1568094670
Dermatology - Procedural Dermatology in Prestonsburg, KY

Active since February 06, 2020CLIA 18D2196777 · Waiver
154 N LAKE DR, PRESTONSBURG, KY 41653(606) 506-5093(606) 506-5039 Get Directions Write a Review

NPPES record last updated: September 2, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 2, 2022, Jun 1, 2021, Jul 21, 2020 and 1 more (4 updates tracked since 2020).

About Commonwealth Community Care Centers, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COMMONWEALTH COMMUNITY CARE CENTERS, LLC (NPI 1568094670) is a healthcare organization registered as a procedural dermatology in Prestonsburg, Kentucky and active in the NPI registry since February 2020. The organization holds a CLIA Waiver certificate valid through October 19, 2026, maintains 3 additional practice locations, and lists Yvette Wisener, Billing, as its authorized official.

NPPES Registry Identity

NPI1568094670
Entity TypeOrganization
Primary Taxonomy207NS0135X
Legal Business NameCOMMONWEALTH COMMUNITY CARE CENTERS, LLC
Location Address154 N LAKE DRPrestonsburg, KY 41653-1270
Mailing Address156 North Lake DrivePrestonburg, KY 41653 · (606) 506-5093 · Fax (606) 506-5039
Phone(606) 506-5093
Fax(606) 506-5039
Organization SubpartNo
Authorized OfficialYvette WisenerBilling · (256) 258-9603
Enumeration DateFebruary 6, 2020
Last NPPES UpdateSeptember 2, 20224 updates tracked since enumeration
NPPES CertifiedSeptember 2, 2022
✔ NPI 1568094670 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatology · Procedural DermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207NS0135X
Definition
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).
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
154 N LAKE DR, Prestonsburg, KY 41653
Open in Google Maps ↗

Secondary Practice Locations 3

Location 14010 DuPont Cir Ste 370Louisville, KY 40207-4881 · Phone (606) 263-4283 · Fax (606) 263-4285
Location 2601 N Shore Dr Ste 203Jeffersonville, IN 47130-3145 · Phone (606) 263-4283 · Fax (606) 263-4285
Location 32008 Merchant DrRichmond, KY 40475-8188 · Phone (606) 263-4283 · Fax (606) 263-4285

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 18D2196777

Commonwealth Community Care Centers · Prestonsburg, KY
Active · expires Oct 19, 2026
CLIA Number18D2196777
Laboratory TypeMobile Laboratory
Certificate Effective DateOctober 20, 2024
Certificate Expiration DateOctober 19, 2026
Laboratory DirectorMr. Benjamin D. Ferguson
Laboratory Phone(606) 263-4283
Laboratory LocationCommonwealth Community Care Centers154 North Lake Drive, Prestonsburg, KY 41653
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NEW DIRECTIONS RECOVERY
Counselor (Addiction (Substance Use Disorder))
154 N LAKE DR
PRESTONSBURG, KY 41653
Floyd County (606) 791-7928
MAUDELLA GRACE JONES APRN, PMHNP
Nurse Practitioner (Family)
154 N LAKE DR
PRESTONSBURG, KY 41653
Floyd County (606) 263-4283

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Commonwealth Community Care Centers, LLC's NPI number?

The NPI number for Commonwealth Community Care Centers, LLC is 1568094670. It was assigned to this organization in the NPPES registry on February 6, 2020.

Where is Commonwealth Community Care Centers, LLC located?

Commonwealth Community Care Centers, LLC is located at 154 N Lake Dr, Prestonsburg, KY 41653. The listed phone number is (606) 506-5093.

What is Commonwealth Community Care Centers, LLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in Procedural Dermatology, with taxonomy code 207NS0135X.

Does Commonwealth Community Care Centers, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 18D2196777) is associated with this NPI, valid through October 19, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Commonwealth Community Care Centers, LLC was last updated on September 2, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.