Individual provider Active NPI

Cynthia L Daniel, PA-C

  • Physician Assistant
  • Corbin, KY
National Provider Identifier
1831143833
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2110 Issued in KY
Practice address
1203 American Greeting Card Rd
Corbin, KY 40701-4811
Phone
(606) 528-7010
NPI assigned
May 22, 2006
Last updated
Dec 13, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1596 MA
Physician Assistant 363A00000X 007441 NY
Medical Physician Assistant 363AM0700X 1803 TN
Physician Assistant 363A00000X TC487 KY
Physician Assistant 363A00000X PA2110 KY Primary

Addresses

Primary practice location

1203 American Greeting Card Rd
Corbin, KY 40701-4811

Mailing address

PO Box 568
Corbin, KY 40702-0568
Phone (606) 528-7010

Other identifiers 3

IdentifierTypeStateIssuer
7100429590MedicaidKY
1520901OtherTNTENNESSEE MEDICAID/TENNCARE PROGRAM
1520901MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160914002697 KY Practitioner - Physician Assistant 8527023829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cumberland River Behavioral Health IncGroup PAC ID 4587561790, 24 clinicians

Practice addresses (Care Compare)

285 Cemetery Rd
Williamsburg, KY 40769-1511
Phone (606) 549-1440

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1803TNMDOccupational Therapy Assistant
1596MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Esd Psychological Services Past Accepting new patients
Wayne E. Tasker and Associates, Inc. Medical Past Accepting new patients
Parkwest Medical Center Past Accepting new patients
Inpatient Consultants of Tennessee, P.C. Physician Assistant Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1831143833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 568",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407020568",
            "telephone_number": "606-528-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 AMERICAN GREETING CARD RD",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407014811",
            "telephone_number": "606-528-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "CYNTHIA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "1596",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "007441",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "1803",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC487",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100429590",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNESSEE MEDICAID/TENNCARE PROGRAM",
            "identifier": "1520901",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1520901",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

Verify at the official NPI Registry.