NPIMap

Organization Active NPI

Cumberland Foot and Ankle Center

  • Foot & Ankle Surgery Podiatrist
  • London, KY
National Provider Identifier
1023324399
Registry record updated Aug 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
CUMBERLAND FOOT AND ANKLE CENTER
Practice address
929 N Main St
London, KY 40741-1122
Phone
(606) 862-0956
Fax
(606) 862-0955
NPI assigned
Aug 25, 2010
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Jonathan E Moore, DPM
Title
Owner/ Podiatrist
Phone
(606) 679-2773

Other NPIs on the same Medicare enrollment 14

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20040322000214 KY Part B Supplier - Clinic/Group Practice 4385535319 Receives reassigned benefits from 24 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bowling Green, KY; Somerset, KY; Russell Springs, KY; Richmond, KY; Mount Vernon, KY; Monticello, KY; Manchester, KY; London, KY…

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X Primary

Addresses

NPPES NPI Registry

Primary practice location

929 N Main St
London, KY 40741-1122

Mailing address

117 Tradepark Dr
Somerset, KY 42503-3428
Phone (606) 679-2773

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
90005091MedicaidKY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 25, 2010.

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282694400000",
    "number": "1023324399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 TRADEPARK DR",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033428",
            "telephone_number": "606-679-2773",
            "fax_number": "606-679-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 N MAIN ST",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407411122",
            "telephone_number": "606-862-0956",
            "fax_number": "606-862-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND FOOT AND ANKLE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-25",
        "last_updated": "2010-08-25",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/ PODIATRIST",
        "authorized_official_telephone_number": "606-679-2773",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90005091",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in London, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.