NPIMap

Organization Active NPI

Grayson County Hospital Foundation Inc.

Doing business as Twin Lakes Regional Medical Center

  • Pain Medicine (Anesthesiology) Physician
  • Elizabethtown, KY
National Provider Identifier
1215406434
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
GRAYSON COUNTY HOSPITAL FOUNDATION INC.
Doing business as
Twin Lakes Regional Medical Center
Practice address
2902 Dolphin Dr
Elizabethtown, KY 42701-7102
Phone
(270) 259-9405
NPI assigned
Nov 16, 2018
Last updated
Nov 30, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
GRAYSON COUNTY HOSPITAL FOUNDATION INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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

Authorized official

Name
Cynthia R Bailey
Title
Reimbursement Analyst
Phone
(270) 259-1656

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X NU Primary

Addresses

Primary practice location

2902 Dolphin Dr
Elizabethtown, KY 42701-7102

Mailing address

910 Wallace Ave
Leitchfield, KY 42754-2414
Phone (270) 259-1656

Other identifiers 1

IdentifierTypeStateIssuer
01006733MedicaidKY

Other names 1

  • TWIN LAKES REGIONAL MEDICAL CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community HLTH Care Plus5 organizations share this tax ID, including this one
Part of
Community HLTH Care Plus

Other organizations with this tax ID 4

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

Locations

910 Wallace Ave
Leitchfield, KY 42754
Phone (270) 259-3035

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1542326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543536000000",
    "number": "1215406434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 WALLACE AVE",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427542414",
            "telephone_number": "270-259-1656",
            "fax_number": "270-259-9536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2902 DOLPHIN DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427017102",
            "telephone_number": "270-259-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAYSON COUNTY HOSPITAL FOUNDATION INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRAYSON COUNTY HOSPITAL FOUNDATION INC.",
        "enumeration_date": "2018-11-16",
        "last_updated": "2018-11-30",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "REIMBURSEMENT ANALYST",
        "authorized_official_telephone_number": "270-259-1656"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01006733",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TWIN LAKES REGIONAL MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elizabethtown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.