NPIMap

Organization Active NPI

Lake Cumberland District Health Department

Doing business as Wayne County Health Department

  • Public Health or Welfare Agency
  • Monticello, KY
National Provider Identifier
1265576953
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
LAKE CUMBERLAND DISTRICT HEALTH DEPARTMENT
Doing business as
Wayne County Health Department
Practice address
39 Jim Hill Service Rd
Monticello, KY 42633-7900
Phone
(606) 348-9340
Fax
(606) 348-7464
NPI assigned
Feb 16, 2007
Last updated
Oct 1, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

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

Authorized official

Name
Mr. Shawn D. Crabtree
Title
Executive Director
Phone
(606) 678-4761

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary

Addresses

Primary practice location

39 Jim Hill Service Rd
Monticello, KY 42633-7900

Mailing address

500 Bourne Ave
Somerset, KY 42501-1916
Phone (606) 678-4761

Other identifiers 18

IdentifierTypeStateIssuer
1437271244OtherKYNPI RENDERING PROVIDER
1568449445OtherKYNPI RENDERING PROVIDER
0300202OtherKYMEDICARE PROVIDER
1265410393OtherKYNPI RENDERING PROVIDER
1629055082OtherKYNPI RENDERING PROVIDER
1760469134OtherKYNPI RENDERING PROVIDER
1588825335OtherKYNPI RENDERING PROVIDER
1780687798OtherKYNPI RENDERING PROVIDER
600000720OtherKYRR MEDICARE
000000047568OtherKYBC/BS PROVIDER NUMBER
1427035872OtherKYNPI RENDERING PROVIDER
1770560716OtherKYNPI RENDERING PROVIDER
1316135783OtherKYNPI RENDERING PROVIDER
15001290OtherKYHANDS MEDICAID
50003866OtherKYPASSPORT MEDICAID
1073590436OtherKYNPI RENDERING PROVIDER
1730326877OtherKYRENDERING PROVIDER
20116018MedicaidKY

Other names 1

  • Wayne County Health Department Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040203000041 KY Part B Supplier - Clinic/Group Practice 4880587138 Receives reassigned benefits from 1 practitioner
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Albany, KY; Whitley City, KY; Somerset, KY; Monticello, KY; Liberty, KY; Jamestown, KY; Greensburg, KY; Columbia, KY…

Other NPIs on the same Medicare enrollment 9

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

National Provider Directory

National Provider Directory
Tax ID family
Lake Cumberland District79 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380585600000",
    "number": "1265576953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 BOURNE AVE",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425011916",
            "telephone_number": "606-678-4761",
            "fax_number": "606-676-9671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 JIM HILL SERVICE RD",
            "city": "MONTICELLO",
            "state": "KY",
            "postal_code": "426337900",
            "telephone_number": "606-348-9340",
            "fax_number": "606-348-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CUMBERLAND DISTRICT HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2013-10-01",
        "status": "A",
        "authorized_official_last_name": "CRABTREE",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "606-678-4761",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI RENDERING PROVIDER",
            "identifier": "1437271244",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI RENDERING PROVIDER",
            "identifier": "1568449445",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER",
            "identifier": "0300202",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI RENDERING PROVIDER",
            "identifier": "1265410393",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI RENDERING PROVIDER",
            "identifier": "1629055082",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI RENDERING PROVIDER",
            "identifier": "1760469134",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI RENDERING PROVIDER",
            "identifier": "1588825335",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI RENDERING PROVIDER",
            "identifier": "1780687798",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "600000720",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER NUMBER",
            "identifier": "000000047568",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI RENDERING PROVIDER",
            "identifier": "1427035872",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI RENDERING PROVIDER",
            "identifier": "1770560716",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI RENDERING PROVIDER",
            "identifier": "1316135783",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HANDS MEDICAID",
            "identifier": "15001290",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT MEDICAID",
            "identifier": "50003866",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI RENDERING PROVIDER",
            "identifier": "1073590436",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RENDERING PROVIDER",
            "identifier": "1730326877",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20116018",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wayne County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monticello, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; 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.