NPIMap

Organization Active NPI

Lake Cumberland Area Development District

  • Supports Brokerage Agency
  • Russell Springs, KY
National Provider Identifier
1831238526
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Supports Brokerage AgencyTaxonomy code 251X00000X
License
089907 Issued in KY
Legal business name
LAKE CUMBERLAND AREA DEVELOPMENT DISTRICT
Practice address
2374 Lakeway Drive
Russell Springs, KY 42642
Phone
(270) 866-4200
Fax
(270) 866-4212
NPI assigned
Feb 6, 2007
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
Donna Diaz
Title
Executive Director
Phone
(270) 866-4200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Supports Brokerage Agency 251X00000X 089907 KY Primary

Addresses

Primary practice location

2374 Lakeway Drive
Russell Springs, KY 42642

Mailing address

PO Box 1570
Russell Springs, KY 42642-1570
Phone (270) 866-4200

Other identifiers 1

IdentifierTypeStateIssuer
4399614900MedicaidKY

National Provider Directory

National Provider Directory
Tax ID family
Lake Cumberland Area Development District3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831238526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1570",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "426421570",
            "telephone_number": "270-866-4200",
            "fax_number": "270-866-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2374 LAKEWAY DRIVE",
            "city": "RUSSELL SPRINGS",
            "state": "KY",
            "postal_code": "42642",
            "telephone_number": "270-866-4200",
            "fax_number": "270-866-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CUMBERLAND AREA DEVELOPMENT DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "270-866-4200"
    },
    "taxonomies": [
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": "KY",
            "license": "089907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4399614900",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russell Springs, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.