Lake Cumberland Gastroenterology and Internal Medicine Assoc. Inc.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

LAKE CUMBERLAND GASTROENTEROLOGY AND INTERNAL MEDICINE ASSOC. INC.

Practice address

110 Hardin LN
Suite 9
Somerset, KY 42503-3818

Phone

(606) 679-7317

Fax

(606) 679-0139

NPI assigned

Jan 31, 2007

Last updated

Jun 21, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Brenda Roback

Title

Office Manager

Phone

(606) 679-7317

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308614400000",
    "number": "1407993074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HARDIN LN",
            "address_2": "SUITE 9",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033818",
            "telephone_number": "606-679-7317",
            "fax_number": "606-679-0139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HARDIN LN",
            "address_2": "SUITE 9",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033818",
            "telephone_number": "606-679-7317",
            "fax_number": "606-679-0139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CUMBERLAND GASTROENTEROLOGY AND INTERNAL MEDICINE ASSOC. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2011-06-21",
        "status": "A",
        "authorized_official_last_name": "ROBACK",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "606-679-7317",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Cumberland District Health Dept (Southern Middle School)
• Lake Cumberland District Health Dept (Pulaski County High School)
• Lake Cumberland District Health Dept (Northern Middle School)
• Lake Cumberland District Health Dept (Southwestern High School)
• Lake Cumberland District Heatlh Dept (Somerset High School)
• Lake Cumberland Neurosurgical Clinic
• Lake Cumberland Neurosurgical Clinic PSC
• Lake Cumberland Pediatric Dentistry
• Lake Cumberland Pediatric Therapy, LLC
• Lake Cumberland Pediatric Therapy, LLC

• Gastroenterology Physician in Somerset, KY
• Providers in Somerset, KY by specialty
• Gastroenterology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; 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.