NPIMap

Organization Active NPI

Livingston Hospital and Healthcare Services, Inc.

  • Multi-Specialty Clinic/Center
  • Grand Rivers, KY
National Provider Identifier
1669612008
Registry record updated Aug 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
900135 Issued in KY
Legal business name
LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC.
Practice address
1860 J.H. O'Bryan Ave.
Grand Rivers, KY 42045
Phone
(270) 362-8246
Fax
(270) 362-9757
NPI assigned
Feb 25, 2009
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Mark A Edwards
Title
Administrator//Ceo
Phone
(270) 988-7235

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D0979196Grand Lakes Clinic1860 J H O'Bryan Ave, Grand Rivers, KY 42045Provider-performed microscopyApr 20, 2027

National Provider Directory

National Provider Directory
Tax ID family
Livingston Hospital Hea13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 900135 KY Primary

Addresses

NPPES NPI Registry

Primary practice location

1860 J.H. O'Bryan Ave.
Grand Rivers, KY 42045

Mailing address

131 Hospital Dr
Salem, KY 42078-8043
Phone (270) 988-7296

Other names 1

NPPES NPI Registry
  • Grand Lakes Clinic Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 5, 2011.

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312502400000",
    "number": "1669612008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 HOSPITAL DR",
            "city": "SALEM",
            "state": "KY",
            "postal_code": "420788043",
            "telephone_number": "270-988-7296",
            "fax_number": "270-988-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 J.H. O'BRYAN AVE.",
            "city": "GRAND RIVERS",
            "state": "KY",
            "postal_code": "42045",
            "telephone_number": "270-362-8246",
            "fax_number": "270-362-9757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-25",
        "last_updated": "2011-08-05",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR//CEO",
        "authorized_official_telephone_number": "270-988-7235",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "KY",
            "license": "900135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Lakes Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rivers, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.