NPIMap

Organization Active NPI

Lake Cumberland Regional Hospital LLC

Doing business as Lake Cumberland Medical Associates

  • Rural Health Clinic/Center
  • Somerset, KY
National Provider Identifier
1023155462
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
LAKE CUMBERLAND REGIONAL HOSPITAL LLC
Doing business as
Lake Cumberland Medical Associates
Practice address
305 Langdon St
Somerset, KY 42503-2750
Phone
(606) 679-7441
NPI assigned
Feb 1, 2007
Last updated
Oct 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Charlotte Lawrence
Title
Secretary
Phone
(615) 920-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

305 Langdon St
Somerset, KY 42503-2750

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-4536
Phone (615) 920-7000

Other names 1

  • Lake Cumberland Medical Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040809001229 KY Part B Supplier - Clinic/Group Practice 7214909456 Receives reassigned benefits from 88 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Whitley City, KY; Somerset, KY
O20071002000407 KY Part A Provider - Rural Health Clinic 7214909456 Practice locations: Somerset, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023155462. Details of each certification follow.

Rural health clinic certification: CCN 183405

Legal name
LAKE CUMBERLAND REGIONAL HOSPITAL LLC
Doing business as
LAKE CUMBERLAND MEDICAL ASSOCIATES
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 6, 1995
Last certification
Jun 19, 2017
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Oct 19, 1998 in DE
Enrollment address
350 Hospital Way 100
Somerset, KY 42503-1872
Related CCNs
180132

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0326777Lake Cumberland Medical Associates350 Hospital Way Suite 100, Somerset, KY 42503AccreditationDec 22, 2027
18D2157873Lake Cumberland Medical Associates350 Hospital Way Suite 100, Somerset, KY 42503Certificate of waiverNov 14, 2026

National Provider Directory

National Provider Directory
Tax ID family
Cumberland Lung Sleep Diso7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10 Tower Cir
Somerset, KY 42503
Phone (606) 425-4895

112 Tradepark Dr
Somerset, KY 42503
Phone (606) 451-3755

27 Imaging Dr
Somerset, KY 42503
Phone (606) 451-0134

329 Bogle St
Ste B
Somerset, KY 42503
Phone (606) 451-6005

341 Bogle St
Ste C
Somerset, KY 42503
Phone (606) 678-3414

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Lifepoint Holdings 2 LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Apr 28, 1999 100%
Lifepoint Corporate Services General Partnership Organization, Brentwood, TN Operational/Managerial Control Apr 15, 2005
William Haugh Individual Corporate OfficerPresident Sep 19, 2022
DSB Acquisition LLC Organization, New York, NY For-profit 5% Or Greater Indirect Ownership Interest Nov 16, 2018 100%
Lifepoint Hospitals Holdings LLC Organization, Brentwood, TN For-profit 5% Or Greater Indirect Ownership Interest Jun 26, 2002 100%
Historic Lifepoint Hospitals, LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Apr 27, 1999 100%
Daniel Davis Individual Corporate OfficerChief Financial Officer Sep 19, 2022
Lifepoint Health Inc Organization, Brentwood, TN For-profit 5% Or Greater Indirect Ownership Interest Nov 16, 2018 100%
Marcus B Poppell Individual Corporate OfficerSenior Vice President Sep 19, 2022
Charlotte E Lawrence Individual Corporate OfficerSecretary Jan 25, 2022
Robert Parker Individual Contracted Managing EmployeeFacility Ceo Aug 27, 2018
John Michael Grooms Individual Corporate OfficerSenior Vice President & Treasurer Nov 1, 2016
Christopher J Monte Individual Corporate OfficerVice President Jun 1, 2014
Legacy Lifepoint Health LLC Organization, Brentwood, TN For-profit 5% Or Greater Indirect Ownership Interest Nov 16, 2018 100%
Lifepoint of Lake Cumberland Organization, Brentwood, TN LLC 5% Or Greater Direct Ownership Interest Dec 19, 1998 100%

Facilities with the same owner 195

Facilities that share an organizational owner with 5% or greater ownership or operational control.

  • Bourbon Community Hospital LLC

    dba Bourbon Community Hospital

    • Rural Acute Care Hospital
    • Paris, KY
    • NPI 1427132158

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Corporate Services General Partnership, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Bourbon Community Hospital LLC

    dba Bourbon Community Hospital

    • Psychiatric Hospital Unit
    • Paris, KY
    • NPI 1902089865

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Corporate Services General Partnership, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Bourbon Physician Practice LLC

    dba Bluegrass Family Clinic

    • Rural Health Clinic/Center
    • Paris, KY
    • NPI 1962111716

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Clark Regional Physician Practices LLC

    dba Centerpoint Family Medicine - Mt. Sterling

    • Rural Health Clinic/Center
    • Mt Sterling, KY
    • NPI 1780356253

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Clark Regional Physician Practices LLC

    dba Centerpoint Family Medicine - Winchester Boonesboro Road

    • Rural Health Clinic/Center
    • Winchester, KY
    • NPI 1831852771

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Clark Regional Physician Practices LLC

    dba Centerpoint Primary Care - Winchester

    • Rural Health Clinic/Center
    • Winchester, KY
    • NPI 1841953783

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Fleming Medical Center LLC

    dba Fleming County Hospital

    • Critical Access Hospital
    • Flemingsburg, KY
    • NPI 1881726347

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Corporate Services General Partnership, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Georgetown Community Hospital LLC

    dba Gerogetown Community Hospital

    • Rural Acute Care Hospital
    • Georgetown, KY
    • NPI 1326107319

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Corporate Services General Partnership, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Kentucky Hospital, LLC

    dba Clark Regional Medical Center

    • General Acute Care Hospital
    • Winchester, KY
    • NPI 1811213994

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Corporate Services General Partnership, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Kentucky in-Home Partner-I, LLC

    dba Lifeline of Jackson Purchase Home Health

    • Home Health Agency
    • Mayfield, KY
    • NPI 1508394594

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Kentucky Mso LLC

    dba Centerpoint Family Medicine - Lawrenceburg

    • Rural Health Clinic/Center
    • Lawrenceburg, KY
    • NPI 1922860758

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC

    CMS ownership
  • Lake Cumberland Regional Hospital LLC

    dba Lake Cumberland Regional Hospital - rehabilitation unit

    • Rehabilitation Hospital Unit
    • Somerset, KY
    • NPI 1346301975

    Historic Lifepoint Hospitals, LLC, Legacy Lifepoint Health LLC, Lifepoint Corporate Services General Partnership, Lifepoint Holdings 2 LLC, Lifepoint Hospitals Holdings LLC, Lifepoint of Lake Cumberland

    CMS ownership
View all 195

Practitioners & affiliated clinicians

Practitioners 92

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 92

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1023155462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274536",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 LANGDON ST",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032750",
            "telephone_number": "606-679-7441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CUMBERLAND REGIONAL HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Cumberland Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Somerset, KY

Sources for this page

Verify at the official NPI Registry.