Organization Active NPI

Lake Cumberland District Health Dept

Doing business as Wayne County High School

  • Public Health or Welfare Agency
  • Monticello, KY
National Provider Identifier
1356486401
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
LAKE CUMBERLAND DISTRICT HEALTH DEPT
Doing business as
Wayne County High School
Practice address
2 Kenny Davis Blvd
Monticello, KY 42633-9479
Phone
(606) 378-5575
Fax
(606) 348-3458
NPI assigned
Feb 20, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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 Primary

Addresses

Primary practice location

2 Kenny Davis Blvd
Monticello, KY 42633-9479

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
20001061MedicaidKY

Other names 1

  • Wayne County High School Doing business as

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

Locations

2 Kenny Davis Blvd
Monticello, KY 42633
Phone (606) 378-5575

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356486401",
    "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": "2 KENNY DAVIS BLVD",
            "city": "MONTICELLO",
            "state": "KY",
            "postal_code": "426339479",
            "telephone_number": "606-378-5575",
            "fax_number": "606-348-3458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CUMBERLAND DISTRICT HEALTH DEPT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20001061",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wayne County High School",
            "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 Aug 22, 2020; 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.