Organization Active NPI

Cumberland Medical Laboratories Inc

  • Clinical Medical Laboratory
  • Somerset, KY
National Provider Identifier
1669440533
Registry record updated May 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
200055 Issued in KY
Legal business name
CUMBERLAND MEDICAL LABORATORIES INC
Practice address
401 Bogle St
Ste 205
Somerset, KY 42501
Phone
(606) 678-8800
Fax
(606) 679-5238
NPI assigned
Mar 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2013

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

Authorized official

Name
Marilyn Mason McMillen, MD
Title
President Medical Director
Phone
(606) 678-8800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X 20206 KY
Clinical Medical Laboratory 291U00000X 200055 KY Primary

Addresses

Primary practice location

401 Bogle St
Ste 205
Somerset, KY 42501

Mailing address

PO Box 3310
W Somerset, KY 42564
Phone (606) 678-8800

Other identifiers 2

IdentifierTypeStateIssuer
37902780MedicaidKY
7100158200MedicaidKY

Other names 1

  • Cumberland Medical Labs Other name

National Provider Directory

National Provider Directory

Locations

401 Bogle St
Ste 205
Somerset, KY 42503
Phone (606) 678-8800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367971200000",
    "number": "1669440533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3310",
            "city": "W SOMERSET",
            "state": "KY",
            "postal_code": "42564",
            "telephone_number": "606-678-8800",
            "fax_number": "606-679-5238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BOGLE ST",
            "address_2": "STE 205",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "42501",
            "telephone_number": "606-678-8800",
            "fax_number": "606-679-5238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND MEDICAL LABORATORIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2013-05-08",
        "status": "A",
        "authorized_official_last_name": "MCMILLEN",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "MASON",
        "authorized_official_title_or_position": "PRESIDENT MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "606-678-8800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KY",
            "license": "20206",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "KY",
            "license": "200055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37902780",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100158200",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cumberland Medical Labs",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; 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.