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ELKHORN DERMATOLOGY PLLC
NPI 1841722980
Dermatology in Georgetown, KY

Active since March 29, 2017CLIA 18D2135045 · Waiver
304 BOSTON SQ, GEORGETOWN, KY 40324(502) 316-9425(502) 316-9451 Get Directions Write a Review

NPPES record last updated: August 24, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 24, 2020, Mar 29, 2017 (2 updates tracked since 2017).

About Elkhorn Dermatology Pllc NPPES

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

ELKHORN DERMATOLOGY PLLC (NPI 1841722980) is a healthcare organization registered as a dermatology in Georgetown, Kentucky and active in the NPI registry since March 2017. The organization holds a CLIA Waiver certificate valid through November 9, 2027 and lists Chase Wilson, Owner, as its authorized official.

NPPES Registry Identity

NPI1841722980
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameELKHORN DERMATOLOGY PLLC
Location Address304 BOSTON SQGeorgetown, KY 40324-9786
Mailing Address304 Boston SqGeorgetown, KY 40324-9786 · (502) 316-9425 · Fax (502) 316-9451
Phone(502) 316-9425
Fax(502) 316-9451
Organization SubpartNo
Authorized OfficialChase WilsonOwner · (502) 316-9425
Enumeration DateMarch 29, 2017
Last NPPES UpdateAugust 24, 20202 updates tracked since enumeration
NPPES CertifiedAugust 24, 2020
✔ NPI 1841722980 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in KY · 49577
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Also ListedNurse PractitionerTaxonomy 363L00000X
304 BOSTON SQ, Georgetown, KY 40324
Open in Google Maps ↗

Group Practice 2

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elkhorn Dermatology Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Elkhorn Dermatology PLLC, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Chase Wilson, M.D.
Dermatology
NPI 1053757641
1158 LEXINGTON RD
Georgetown, KY 40324
(502) 316-9425
✔ PECOS✔ Accepts Medicare2.2 mi
Kathryn Hayes, APRN
Nurse Practitioner
NPI 1831854934
1221 S BROADWAY
Lexington, KY 40504
(859) 258-4000
✔ PECOS✔ Accepts Medicare12 mi
Jessica Smith, APRN
Nurse Practitioner
NPI 1376996629
3475 RICHMOND RD STE 200
Lexington, KY 40509
(859) 296-4400
✔ PECOS✔ Accepts Medicare16 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 18D2135045

Elkhorn Dermatology, PLLC · Georgetown, KY
Active · expires Nov 9, 2027
CLIA Number18D2135045
Laboratory TypePhysician Office
Certificate Effective DateNovember 10, 2025
Certificate Expiration DateNovember 9, 2027
Laboratory DirectorDr. Chase L. Wilson
Laboratory Phone(502) 316-9425
Laboratory LocationElkhorn Dermatology, PLLC1158 Lexington Rd, Georgetown, KY 40324
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Elkhorn Dermatology PLLC's NPI number?

The NPI number for Elkhorn Dermatology PLLC is 1841722980. It was assigned to this organization in the NPPES registry on March 29, 2017.

Where is Elkhorn Dermatology PLLC located?

Elkhorn Dermatology PLLC is located at 304 Boston Sq, Georgetown, KY 40324. The listed phone number is (502) 316-9425.

What is Elkhorn Dermatology PLLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Elkhorn Dermatology PLLC enrolled in Medicare?

Yes. Elkhorn Dermatology PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Elkhorn Dermatology PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Elkhorn Dermatology PLLC, in Dermatology and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Elkhorn Dermatology PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 18D2135045) is associated with this NPI, valid through November 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Elkhorn Dermatology PLLC accept?

Health plans from Anthem Blue Cross and Blue Shield list Elkhorn Dermatology PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Elkhorn Dermatology PLLC was last updated on August 24, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.