Cynthia Surer Maggard, ARNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Manchester, KY
NPI 1659611622 · NPPES record last updated Sep 30, 2024
Key facts
- NPI
- 1659611622
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 3007930 (KY)
- Practice address
- 56 Marie Langdon Dr
Manchester, KY 40962-6329 - Phone
- (606) 599-4080
- Fax
- (606) 598-0983
- NPI assigned
- Feb 27, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 9
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Memorial Hospital, Inc.
Practice addresses (Care Compare)
56 Marie Langdon Dr
Manchester, KY 40962-6329
Phone (606) 599-4080
Hospital & facility affiliations
- Mary Breckinridge Arh Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130702000838 | KY | Practitioner - Nurse Practitioner | 0941440580 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3007930 | KY | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital Inc. | Family | Current |
Accepting new patients |
| Memorial Hospital, Inc. | Family | Current |
Accepting new patients |
Locations
210 Marie Langdon Dr
Manchester, KY 40962
Phone (865) 985-7047
1033 N Highway 11
Manchester, KY 40962
Phone (606) 598-6163
509 Memorial Dr
Ste 2
Manchester, KY 40962
Phone (606) 598-4384
Interoperability endpoints
- cmaggard659526@adventhealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3007930 | KY | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 3007930 | KY | Yes |
Addresses
Primary practice location
56 Marie Langdon Dr
Manchester, KY 40962-6329
Mailing address
210 Marie Langdon Dr
Manchester, KY 40962-6388
Phone (606) 598-5104
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100243440 | Medicaid | KY | |
| P01427258 | Other | KY | RR MEDICARE |
| 12536601 | Other | CAQH ID |
Other providers in Manchester, KY
- Sarah Mackenzie Lawson
- Michael Shawn Ledford
- Rodney Ledford
- Carla Joan Lewis
- Living Clean LLC
- Magnolia Tree Therapy, LLC
- Manchester Down Home Pharmacy LLC
- Manchester Family Practice Clinic
- Manchester Family Practice Clinic, Inc.
- Manchester Pharmacist Group LLC
All providers in Manchester, KY · Psychiatric/Mental Health Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.