COMMONWEALTH COMMUNITY CARE CENTERS LLC NPI 1568094670

NPI Information

  • NPI: 1568094670
  • Provider Name: COMMONWEALTH COMMUNITY CARE CENTERS, LLC
  • Classification: Dermatology - 207NS0135X
  • Specialization: Procedural Dermatology
  • Entity Type: Organization
  • CLIA Number: 18D2196777
  • Address: 154 N LAKE DR
    PRESTONSBURG, KY
    ZIP 41653
  • Phone: (606) 506-5093

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NPI Details

COMMONWEALTH COMMUNITY CARE CENTERS, LLC is a procedural dermatology dermatology in Prestonsburg, KY. The provider is 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). COMMONWEALTH COMMUNITY CARE CENTERS, LLC NPI is 1568094670. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

154 N LAKE DR
PRESTONSBURG, KY
ZIP 41653-270
Phone: (606) 506-5093
Fax: (606) 506-5039

The provider's authorized official is Yvette Wisener .
The authorized official title is Billing and has the following contact phone number (256) 258-9603.

The CLIA number assigned to this NPI record is 18D2196777 - mobile laboratory with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/6/2020 and was last updated on 9/2/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207V00000XObstetrics & GynecologyNo
2363LF0000XNurse PractitionerFamilyNo
3207NS0135XDermatologyProcedural DermatologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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