Organization Active NPI

Cumberland Valley Dist Health Dept

  • Public Health or Welfare Agency
  • Manchester, KY
National Provider Identifier
1902074420
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
CUMBERLAND VALLEY DIST HEALTH DEPT
Practice address
239 Richmond Rd
Manchester, KY 40962-1208
Phone
(606) 598-1810
NPI assigned
Feb 19, 2008
Last updated
Feb 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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 NU Primary

Addresses

Primary practice location

239 Richmond Rd
Manchester, KY 40962-1208

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
20026027MedicaidKY

Other names 1

  • Clay Co- Clay Co Middle School 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": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1902074420",
    "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": "239 RICHMOND RD",
            "city": "MANCHESTER",
            "state": "KY",
            "postal_code": "409621208",
            "telephone_number": "606-598-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND VALLEY DIST HEALTH DEPT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-02-19",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20026027",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clay Co- Clay Co Middle School",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Manchester, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.