Organization Active NPI

Cumberland Foot and Ankle Centers

  • Foot & Ankle Surgery Podiatrist
  • Liberty, KY
National Provider Identifier
1477073955
Registry record updated Jun 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
CUMBERLAND FOOT AND ANKLE CENTERS
Practice address
511 Middleburg St
Liberty, KY 42539-3009
Phone
(606) 787-6963
Fax
(606) 787-5545
NPI assigned
Jun 26, 2017
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Jonathan E Moore, DPM
Title
Associate Partner/Podiatrist
Phone
(606) 679-2773

Corporate family (same tax ID) 12

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

National Provider Directory

Tax ID family
Cumberland Foot and Ankle Centers (13 organizations share this tax ID)

Specialties & licenses 4

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

NPPES NPI Registry

Primary practice location

511 Middleburg St
Liberty, KY 42539-3009

Mailing address

117 Tradepark Dr Ste B
Somerset, KY 42503-3428
Phone (606) 679-2773

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
7100207030MedicaidKY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 26, 2017.

{
    "created_epoch": "1498435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498435200000",
    "number": "1477073955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 TRADEPARK DR STE B",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033428",
            "telephone_number": "606-679-2773",
            "fax_number": "606-679-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 MIDDLEBURG ST",
            "city": "LIBERTY",
            "state": "KY",
            "postal_code": "425393009",
            "telephone_number": "606-787-6963",
            "fax_number": "606-787-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND FOOT AND ANKLE CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-26",
        "last_updated": "2017-06-26",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ASSOCIATE PARTNER/PODIATRIST",
        "authorized_official_telephone_number": "606-679-2773",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100207030",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2017; 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.