Active NPI
Cumberland Gastroenterology, P.S.C.
- Gastroenterology Physician
- Monticello, KY
National Provider Identifier
1720160526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 34871
- Legal business name
- CUMBERLAND GASTROENTEROLOGY, P.S.C.
- Practice address
- 1 Southcreek Drive
Monticello, KY 42633 - Phone
- (606) 677-2913
- Fax
- (606) 677-6983
- NPI assigned
- Oct 20, 2006
- Last updated
- Mar 24, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Samir Issa Cook, M.D.
- Title
- President
- Phone
- (606) 677-2913
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 34871 | KY | Primary |
| Nurse Practitioner | 363L00000X | 2617P | KY |
Addresses
Primary practice location
1 Southcreek Drive
Monticello, KY 42633
Mailing address
56 Tower Circle
Somerset, KY 42503
Phone (606) 677-2913
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64384712 | Medicaid | KY | |
| 65933517 | Medicaid | KY |
National Provider Directory
National Provider Directory- Tax ID family
- Cumberland Gastroenterology PSC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Nurse Practitioner
- Somerset, KY
- NPI 1831505478
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Gastroenterology Physician
- Somerset, KY
- NPI 1629075296
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1300924800000",
"number": "1720160526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 TOWER CIRCLE",
"city": "SOMERSET",
"state": "KY",
"postal_code": "42503",
"telephone_number": "606-677-2913",
"fax_number": "606-677-6983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 SOUTHCREEK DRIVE",
"city": "MONTICELLO",
"state": "KY",
"postal_code": "42633",
"telephone_number": "606-677-2913",
"fax_number": "606-677-6983"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CUMBERLAND GASTROENTEROLOGY, P.S.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-20",
"last_updated": "2011-03-24",
"status": "A",
"authorized_official_last_name": "COOK",
"authorized_official_first_name": "SAMIR",
"authorized_official_middle_name": "ISSA",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "606-677-2913",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": "KY",
"license": "34871",
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "2617P",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64384712",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "65933517",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monticello, KY
- Cumberland Family Medical Center Inc (Wayne County Middle Healthy Kids Clinic)
- Cumberland Family Medical Center Inc (Bell Elementary Healthy Kids Clinic)
- Cumberland Family Medical Center Inc (Wayne County High Healthy Kids Clinic)
- Cumberland Family Medical Center Inc (Wayne County Healthy Kids Clinic Annex)
- Cumberland Foot and Ankle Center
- Cumberland Valley Behavioral Health LLC
- Misty A Cundiff, APRN
- David B Mayer D O P S C
- Wendy Parnell Denney, LPCC
- Michelle Dennis, APRN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.