NPIMap

Organization Active NPI

Cumberland Foot & Ankle Centers

  • Foot & Ankle Surgery Podiatrist
  • Somerset, KY
National Provider Identifier
1093901100
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
CUMBERLAND FOOT & ANKLE CENTERS
Practice address
117 Tradepark Dr Ste B
Somerset, KY 42503-3428
Phone
(606) 679-2773
Fax
(606) 679-4626
NPI assigned
Sep 21, 2007
Last updated
Mar 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Authorized official

Name
Ms. Martha J Lee
Title
Office/Business Manager
Phone
(606) 679-2773

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X NU
Durable Medical Equipment & Medical Supplies 332B00000X NU
Family Nurse Practitioner 363LF0000X NU
Orthopaedic Surgery Physician 207X00000X KY
Foot & Ankle Surgery Podiatrist 213ES0103X KY Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

117 Tradepark Dr Ste B
Somerset, KY 42503-3428

Mailing address

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

Other identifiers 3

IdentifierTypeStateIssuer
7100207030MedicaidKY
CK4991OtherKYRAILROAD MEDICARE
7100234690MedicaidKY

Medicare participation

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

Enrollment records 1

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
Practice locations: Bowling Green, KY; Somerset, KY; Russell Springs, KY; Richmond, KY; Mount Vernon, KY; Monticello, KY; Manchester, KY; London, KY…

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory

Locations

1850 Westen St
Bowling Green, KY 42104
Phone (270) 846-3338

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1093901100",
    "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": "117 TRADEPARK DR STE B",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033428",
            "telephone_number": "606-679-2773",
            "fax_number": "606-679-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND FOOT & ANKLE CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-21",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE/BUSINESS MANAGER",
        "authorized_official_telephone_number": "606-679-2773",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "KY",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100207030",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK4991",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100234690",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Mar 16, 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.