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PADUCAH DERMATOLOGY SURGERY CENTER PLLC
NPI 1689401465
Clinic/Center - Ambulatory Surgical in Paducah, KY

Active since September 17, 2024CLIA Certified · 3 labs
127 ALBEN BARKLEY DRIVE SUITE A, PADUCAH, KY 42001(270) 444-8477(270) 444-8479 Get Directions Write a Review

NPPES record last updated: December 8, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 8, 2025, Nov 24, 2025, May 9, 2025 and 1 more (4 updates tracked since 2024).

About Paducah Dermatology Surgery Center Pllc NPPES

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

PADUCAH DERMATOLOGY SURGERY CENTER PLLC (NPI 1689401465) is a healthcare organization registered as an ambulatory surgical in Paducah, Kentucky and active in the NPI registry since September 2024. The organization holds 3 active CLIA laboratory certificates and lists Erica Housman, Asc Administrator, as its authorized official.

NPPES Registry Identity

NPI1689401465
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NamePADUCAH DERMATOLOGY SURGERY CENTER PLLC
Location Address127 ALBEN BARKLEY DRIVE SUITE APaducah, KY 42001
Mailing Address127 Alben Barkley Dr Ste APaducah, KY 42001-4402 · (270) 444-8477 · Fax (270) 444-8479
Phone(270) 444-8477
Fax(270) 444-8479
Organization SubpartNo
Authorized OfficialErica HousmanAsc Administrator · (270) 444-8477
Enumeration DateSeptember 17, 2024
Last NPPES UpdateDecember 8, 20254 updates tracked since enumeration
NPPES CertifiedDecember 8, 2025
✔ NPI 1689401465 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
127 ALBEN BARKLEY DRIVE SUITE A, Paducah, KY 42001
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CLIA Laboratory Certificates CMS CLIA 3

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 18D2315830

Paducah Dermatology Surgery Center, PLLC · Paducah, KY
Active · expires Dec 18, 2026
CLIA Number18D2315830
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateDecember 19, 2024
Certificate Expiration DateDecember 18, 2026
Laboratory DirectorDr. Joseph Blackmon
Laboratory Phone(270) 444-8477
Laboratory LocationPaducah Dermatology Surgery Center, PLLC127 Alben Barkley Dr Suite A, Paducah, KY 42001
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 18D2314165

Paducah Dermatology, PLLC · Paducah, KY
Active · expires Mar 17, 2028
CLIA Number18D2314165
Laboratory TypePhysician Office
Certificate Effective DateMarch 18, 2026
Certificate Expiration DateMarch 17, 2028
Laboratory DirectorDr. Joseph Blackmon
Laboratory Phone(270) 444-8477
Laboratory LocationPaducah Dermatology, PLLC127 Alben Barkley Suite B, Paducah, KY 42001
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 18D0875591

Paducah Dermatology · Paducah, KY
Active · expires Nov 26, 2026
CLIA Number18D0875591
Laboratory TypePhysician Office
Certificate Effective DateNovember 27, 2024
Certificate Expiration DateNovember 26, 2026
Laboratory DirectorDr. Joseph Blackmon
Laboratory Phone(270) 444-8477
Laboratory LocationPaducah Dermatology3101 Parisa Drive, Paducah, KY 42003
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions

What is PADUCAH DERMATOLOGY SURGERY CENTER PLLC's NPI number?

The NPI number assigned to this healthcare provider is 1689401465, enumerated as an "organization" on September 17, 2024.

Where is the provider located?

The provider is located at 127 ALBEN BARKLEY DRIVE SUITE A PADUCAH, KY 42001 and the phone number is (270) 444-8477.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.