NPIMap

Organization Active NPI

Twin Lakes Anesthesiology and Pain Management Associates

  • Pain Medicine (Anesthesiology) Physician
  • Leitchfield, KY
National Provider Identifier
1114968005
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
TP490 Issued in KY
Legal business name
TWIN LAKES ANESTHESIOLOGY AND PAIN MANAGEMENT ASSOCIATES
Practice address
904 Wallace Ave
Leitchfield, KY 42754-1418
Phone
(270) 259-9470
Fax
(270) 259-1662
NPI assigned
Jun 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Authorized official

Name
Mrs. Janet L. Langdon
Title
Office Manager
Phone
(270) 259-9470

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X TP490 KY Primary

Addresses

Primary practice location

904 Wallace Ave
Leitchfield, KY 42754-1418

Mailing address

904 Wallace Ave
Leitchfield, KY 42754-1418
Phone (270) 259-9470

Other identifiers 3

IdentifierTypeStateIssuer
50011448OtherKYPASSPORT
000000485100OtherKYBLUE PREFERRED
274629400OtherKYPASSPORT ADVANTAGE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1114968005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 WALLACE AVE",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427541418",
            "telephone_number": "270-259-9470",
            "fax_number": "270-259-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 WALLACE AVE",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427541418",
            "telephone_number": "270-259-9470",
            "fax_number": "270-259-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN LAKES ANESTHESIOLOGY AND PAIN MANAGEMENT ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "LANGDON",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "270-259-9470",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "KY",
            "license": "TP490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50011448",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE PREFERRED",
            "identifier": "000000485100",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "274629400",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leitchfield, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; 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.