Lake Cumberland Cardiology Associates LLC

Primary specialty

Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X

Legal business name

LAKE CUMBERLAND CARDIOLOGY ASSOCIATES LLC

Doing business as

Lake Cumberland Cardiology Associates

Practice address

50 Medpark Square
Ste 1
Somerset, KY 42503

Phone

(606) 678-0599

NPI assigned

Sep 28, 2009

Last updated

Jul 19, 2025By 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

Charlotte Lawrence

Title

Secretary

Phone

(615) 920-7000

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Lake Cumberland Cardiology Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in KY, FL, NY, MA, CA, PA6 enrollments

Enrollment records 6

Locations

Practitioners 21

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.

• Jessica Diane Bailey, APRN

  • Primary Care Nurse Practitioner
  • Columbia, KY
  • NPI 1427790039
  Medicare reassignment Care Compare group NPD
• Erin Blasko

  • Nurse Practitioner
  • Somerset, KY
  • NPI 1669846309
  Medicare reassignment Care Compare group NPD
• Elizabeth Erin Combs, FNP-C

  • Neurological Surgery Physician
  • Somerset, KY
  • NPI 1063173904

  Family

  Medicare reassignment Care Compare group NPD
• Charlotte Kaye Hayes

  • Acute Care Nurse Practitioner
  • Somerset, KY
  • NPI 1497494512
  Medicare reassignment Care Compare group NPD
• Jeana Lee Keith, APRN-CNP

  • Primary Care Nurse Practitioner
  • Somerset, KY
  • NPI 1780448928
  Medicare reassignment Care Compare group NPD
• Michael Eugene McKinney, MD

  • Cardiovascular Disease Physician
  • Somerset, KY
  • NPI 1295724771
  Medicare reassignment Care Compare group NPD
• Hassan Tahir, MD

  • Interventional Cardiology Physician
  • Cincinnati, OH
  • NPI 1164830824

  Cardiovascular Disease, KY

  Medicare reassignment Care Compare group NPD
• Amber Dawn Parker, APRN

  • Adult Health Clinical Nurse Specialist
  • Somerset, KY
  • NPI 1023525805
  Medicare reassignment NPD
• Matthew K. Shotwell, M.D.

  • Interventional Cardiology Physician
  • Maysville, KY
  • NPI 1912975608

  Cardiovascular Disease

  Medicare reassignment NPD
• Megan Taylor Pittman

  • Family Nurse Practitioner
  • Mount Vernon, KY
  • NPI 1851878318
  Medicare reassignment NPD
• Tarek Abou-Ghazala, M.D.

  • Cardiovascular Disease Physician
  • Reston, VA
  • NPI 1609867381

  KY

  Medicare reassignment NPD
• Angela Nicole Coffey, FNP-C

  • Family Nurse Practitioner
  • Raleigh, NC
  • NPI 1790458875

  KY

  Medicare reassignment NPD

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752883200000",
    "number": "1558695262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MEDPARK SQUARE",
            "address_2": "STE 1",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "42503",
            "telephone_number": "606-678-0599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Tradepark Dr",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "KY",
            "postal_code": "425033454",
            "country_code": "US",
            "telephone_number": "606-678-0599",
            "fax_number": "606-678-0608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKE CUMBERLAND CARDIOLOGY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-28",
        "last_updated": "2025-07-19",
        "certification_date": "2025-07-19",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100108260",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Cumberland Cardiology Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lake Cumberland Cardiology Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• L&M Medical Equipment, Inc (Pulmonary Home Care)
• Ladies Clinic , PSC
• Holly Lafavers, DI
• Linda Renee Lafavers, LPCA
• Lake City Surgical Assistants LLC
• Lake Cumberland Cardiovascular Associates
• Lake Cumberland Child Development, Inc
• Lake Cumberland Community Action Agency, Inc.
• Lake Cumberland Community Action Agency, Inc.
• Lake Cumberland District Health (Hopkins Elementary School)

• Clinical Cardiac Electrophysiology Physician in Somerset, KY
• Providers in Somerset, KY by specialty
• Clinical Cardiac Electrophysiology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2025; 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.