NPIMap

Organization Active NPI

Lake Cumberland Regional Hospital LLC

Doing business as Lake Cumberland Surgical Associates

  • Family Nurse Practitioner
  • Somerset, KY
National Provider Identifier
1093092744
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
LAKE CUMBERLAND REGIONAL HOSPITAL LLC
Doing business as
Lake Cumberland Surgical Associates
Practice address
353 Bogle St
Suite a
Somerset, KY 42503-2888
Phone
(606) 451-6005
Fax
(606) 678-2087
NPI assigned
Nov 9, 2011
Last updated
Oct 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

353 Bogle St
Suite a
Somerset, KY 42503-2888

Mailing address

353 Bogle St
Suite a
Somerset, KY 42503-2888
Phone (606) 451-6005

Other names 1

  • Lake Cumberland Surgical Associates Doing business as

Medicare participation

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

Enrollment records 1

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

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
The Heart Lung Institute O7 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

353 Bogle St
Ste A
Somerset, KY 42503
Phone (606) 451-3820

Practitioners & affiliated clinicians

Practitioners 65

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 65

NPI Registry JSON

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

{
    "created_epoch": "1320796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665100800000",
    "number": "1093092744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 BOGLE ST",
            "address_2": "SUITE A",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032888",
            "telephone_number": "606-451-6005",
            "fax_number": "606-678-2087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 BOGLE ST",
            "address_2": "SUITE A",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032888",
            "telephone_number": "606-451-6005",
            "fax_number": "606-678-2087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CUMBERLAND REGIONAL HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-09",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "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": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Cumberland Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lake Cumberland Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.