NPIMap

Organization Active NPI

Livingston Hospital and Healthcare Services, Inc., Cah

  • Multi-Specialty Clinic/Center
  • Smithland, KY
National Provider Identifier
1104874858
Registry record updated Apr 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
600071 Issued in KY
Legal business name
LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC., CAH
Practice address
205 E Adair Street
Smithland, KY 42081
Phone
(270) 928-2146
Fax
(270) 928-4492
NPI assigned
May 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2008

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

Authorized official

Name
Mr. Michael J Budnick
Title
Chief Executive Officer
Phone
(270) 988-2299

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 600071 KY Primary

Addresses

Primary practice location

205 E Adair Street
Smithland, KY 42081

Mailing address

131 Hospital Dr
Salem, KY 42078-8043
Phone (270) 988-2299

Other identifiers 1

IdentifierTypeStateIssuer
65944019MedicaidKY

Other names 1

  • Smithland Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031230000015 KY Part B Supplier - Clinic/Group Practice 5799692547 Receives reassigned benefits from 23 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Salem, KY; Grand Rivers, KY; Eddyville, KY; Marion, KY

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1104874858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 HOSPITAL DR",
            "city": "SALEM",
            "state": "KY",
            "postal_code": "420788043",
            "telephone_number": "270-988-2299",
            "fax_number": "270-988-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E ADAIR STREET",
            "city": "SMITHLAND",
            "state": "KY",
            "postal_code": "42081",
            "telephone_number": "270-928-2146",
            "fax_number": "270-928-4492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC., CAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "BUDNICK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "270-988-2299",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "KY",
            "license": "600071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65944019",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smithland Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smithland, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; 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.