NPIMap

Organization Active NPI

Cumberland Foot and Ankle Centers

  • Foot Surgery Podiatrist
  • Bowling Green, KY
National Provider Identifier
1053819904
Registry record updated Jan 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
Legal business name
CUMBERLAND FOOT AND ANKLE CENTERS
Practice address
1850 Westen Street
Bowling Green, KY 42104
Phone
(270) 846-3338
Fax
(270) 846-3318
NPI assigned
Jan 25, 2018
Last updated
Jan 25, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2018

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

Authorized official

Name
Jonathan E Moore, DPMNPI 1558339440
Title
President/Podiatrist
Phone
(606) 679-2773

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU
Orthopaedic Surgery Physician 207X00000X NU
Foot Surgery Podiatrist 213ES0131X NU Primary

Addresses

Primary practice location

1850 Westen Street
Bowling Green, KY 42104

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
7100207030MedicaidKY
7100234690MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
Cumberland Foot and Ankle Centers13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1516838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516838400000",
    "number": "1053819904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 TRADEPARK DR STE B",
            "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": "1850 WESTEN STREET",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42104",
            "telephone_number": "270-846-3338",
            "fax_number": "270-846-3318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND FOOT AND ANKLE CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-25",
        "last_updated": "2018-01-25",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT/PODIATRIST",
        "authorized_official_telephone_number": "606-679-2773",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100207030",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100234690",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.