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LAKE CUMBERLAND PHYSICIAN PRACTICES LLC NPI 1437440054


NPI Information

NPI: 1437440054
Provider Name: LAKE CUMBERLAND PHYSICIAN PRACTICES LLC

Doing Business As: LAKE CUMBERLAND FAMILY CARE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 18D2026793

Address:
30 TOWER CIR
SOMERSET, KY
ZIP 42503
Phone: (606) 451-8644
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LAKE CUMBERLAND PHYSICIAN PRACTICES LLC is a family medicine in Somerset, KY. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. LAKE CUMBERLAND PHYSICIAN PRACTICES LLC NPI is 1437440054. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Lake Cumberland Family Care.

The provider's business location address is:

30 TOWER CIR
SOMERSET, KY
ZIP 42503-476
Phone: (606) 451-8644
Fax: (606) 451-9644

The provider's authorized official is Kathy Teague .
The authorized official title is Secretary / Authorized Official and has the following contact phone number (615) 920-7000.

The CLIA number assigned to this NPI record is 18D2026793 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/30/2011 and was last updated on 8/28/2019.


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
1207R00000XInternal MedicineNo
2363A00000XPhysician AssistantNo
3363L00000XNurse PractitionerNo
4207Q00000XFamily MedicineYes

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
17100173010MEDICAIDKENTUCKY

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: 11/14/2023

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