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LAKE CUMBERLAND PHYSICIAN PRACTICES LLC NPI 1700198884


NPI Information

NPI: 1700198884
Provider Name: LAKE CUMBERLAND PHYSICIAN PRACTICES LLC

Doing Business As: SPORTS MEDICINE AND ORTHOPAEDIC CENTER OF LAKE CUMBERLAND

Classification: Orthopaedic Surgery - 207XX0005X
Entity Type: Organization

Specialization: Sports Medicine

Address:
353 BOGLE ST
SUITE C
SOMERSET, KY
ZIP 42503
Phone: (606) 678-2220
Get Directions

LAKE CUMBERLAND PHYSICIAN PRACTICES LLC is a sports medicine orthopaedic surgery in Somerset, KY. The provider is an orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. LAKE CUMBERLAND PHYSICIAN PRACTICES LLC NPI is 1700198884. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Sports Medicine And Orthopaedic Center Of Lake Cumberland.

The provider's business location address is:

353 BOGLE ST
SUITE C
SOMERSET, KY
ZIP 42503-888
Phone: (606) 678-2220
Fax: (606) 451-0595

The provider's authorized official is Sara Miller .
The authorized official title is Director and has the following contact phone number (615) 920-7514.

The enumeration date for this NPI number is 7/6/2010 and was last updated on 9/27/2017.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207X00000XOrthopaedic SurgeryNo
2207XX0005XOrthopaedic SurgerySports MedicineYes
3332B00000XDurable Medical Equipment & Medical SuppliesNo
4363A00000XPhysician AssistantNo
5363LF0000XNurse PractitionerFamilyNo

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
17100136480MEDICAIDKENTUCKY
2P100022773MEDICARE PINKENTUCKY

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: 4/28/2024

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