Organization Active NPI

Cumberland Valley Dist. HLTH Dept

  • Public Health or Welfare Agency
  • Harlan, KY
National Provider Identifier
1770625964
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
CUMBERLAND VALLEY DIST. HLTH DEPT
Practice address
402 E Clover St
Harlan, KY 40831-2312
Phone
(606) 573-4820
Fax
(606) 573-6128
NPI assigned
Feb 13, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Herman Johnson
Title
Administrator
Phone
(606) 598-5564

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

402 E Clover St
Harlan, KY 40831-2312

Mailing address

PO Box 158
Manchester Square Shopping Ctr. Room 212
Manchester, KY 40962-0158
Phone (606) 598-5564

Other names 1

  • Harlan Co. Health Dept. Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031121000660 KY Part B Supplier - Clinic/Group Practice 1456255330 Receives reassigned benefits from 3 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Manchester, KY; MC Kee, KY; Mount Vernon, KY

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1770625964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "address_2": "MANCHESTER SQUARE SHOPPING CTR. ROOM 212",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409620158",
            "telephone_number": "606-598-5564",
            "fax_number": "606-598-6615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 E CLOVER ST",
            "city": "HARLAN",
            "state": "KY",
            "postal_code": "408312312",
            "telephone_number": "606-573-4820",
            "fax_number": "606-573-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND VALLEY DIST. HLTH DEPT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "HERMAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "606-598-5564"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harlan Co. Health Dept.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Harlan, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.