Lake Cumberland Surgery Center LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

300141 Issued in KY

Legal business name

LAKE CUMBERLAND SURGERY CENTER LP

Practice address

301 Langdon St
Somerset, KY 42503-2750

Phone

(606) 678-9688

Fax

(606) 679-7479

NPI assigned

Dec 27, 2006

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 1

Addresses

Other identifiers 3

Other names 1

• Lake Cumberland Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Listed as

Lake Cumberland Surgery Center LPCCN 18C0001034

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://97465a19-0dc7-4ef3-9aea-f72e472d3305.gastro.prod.fhir.ema-api.com/fhir/r4/

Practitioners 43

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

• Sharon Adams, APRN

  • Family Nurse Practitioner
  • Somerset, KY
  • NPI 1821324278
  NPD (past)
• Gustavo Anton, DO

  • Neurological Surgery Physician
  • Somerset, KY
  • NPI 1841789534
  NPD (past)
• Lesia Chaffins

  • Physician Assistant
  • Berea, KY
  • NPI 1174364152
  NPD (past)
• Danielle Elizabeth Clark, APRN

  • Family Nurse Practitioner
  • Lexington, KY
  • NPI 1699324566
  NPD (past)
• Samir Issa Cook, M.D.

  • Gastroenterology Physician
  • Somerset, KY
  • NPI 1629075296
  NPD (past)
• Joseph Eid, MD

  • Surgery Physician
  • Somerset, KY
  • NPI 1467894113
  NPD (past)
• Magdy M El-Kalliny, M.D.

  • Neurological Surgery Physician
  • Somerset, KY
  • NPI 1275504730
  NPD (past)
• Amr Osman El-Naggar, M.D.

  • Neurological Surgery Physician
  • Somerset, KY
  • NPI 1033180757
  NPD (past)
• Joseph L Garland, PA-C

  • Physician Assistant
  • Somerset, KY
  • NPI 1649277971
  NPD (past)
• Sarah E Godbey, PA-C

  • Surgical Physician Assistant
  • Somerset, KY
  • NPI 1558794362
  NPD (past)
• Robin Shawn Goff, APRN

  • Family Nurse Practitioner
  • Somerset, KY
  • NPI 1710381124
  NPD (past)
• Pennie Christine Haste

  • Primary Care Nurse Practitioner
  • Somerset, KY
  • NPI 1922730605
  NPD (past)

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779840000000",
    "number": "1720143779",
    "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": "615-920-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 LANGDON ST",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032750",
            "telephone_number": "606-678-9688",
            "fax_number": "606-679-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CUMBERLAND SURGERY CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "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": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "KY",
            "license": "300141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36001246",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000288161",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE ASC",
            "identifier": "P00000869",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Cumberland Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lake Cumberland Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lake Cumberland Regional MH/Mr Board, Inc.
• Lake Cumberland Regional MH/Mr Board, Inc.
• Lake Cumberland Regional MHMR Board
• Lake Cumberland Regional MHMR Board Outpatient
• Lake Cumberland Rheumatology, PLLC
• Lake Cumberland Surgical Assistants LLC
• Lake Cumberland Surgical Consultants PSC
• Lake Cumberland Womens Health Specialists,PSC
• Laker Dental
• Lakeside Primary Care, PSC

• All providers in Somerset, KY
• Ambulatory Surgical Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.