LAKE CUMBERLAND PEDIATRICS PLLC NPI 1518406859

NPI Information

NPI: 1518406859
Provider Name: LAKE CUMBERLAND PEDIATRICS PLLC
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

CLIA Number: 18D2127165

Address:
268 ROLLING HILLS BLVD.
MONTICELLO, KY
ZIP 42633
Phone: (606) 753-0293
Get Directions

LAKE CUMBERLAND PEDIATRICS PLLC is a rural health clinic center in Monticello, KY. LAKE CUMBERLAND PEDIATRICS PLLC NPI is 1518406859. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

268 ROLLING HILLS BLVD.
MONTICELLO, KY
ZIP 42633-004
Phone: (606) 753-0293
Fax: (606) 753-0291

The provider's authorized official is Joseph Clay Brown .
The authorized official title is Owner and has the following contact phone number (606) 753-0293.

The CLIA number assigned to this NPI record is 18D2127165 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/20/2017 and was last updated on 5/27/2022.

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
1	207R00000X	Internal Medicine				No
2	208000000X	Pediatrics				No
3	363LF0000X	Nurse Practitioner	Family			No
4	261QR1300X	Clinic/Center	Rural Health	900327	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	7100462460	OTHER	KENTUCKY	NP GROUP MEDICAID
2	900327	OTHER	KENTUCKY	RHC LIC
3	18-8969	OTHER	KENTUCKY	MEDICARE PART A
4	7100447120	MEDICAID	KENTUCKY

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: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »