NPIMap

Organization Active NPI

Lake Cumberland Pediatric Therapy, LLC

  • Physical Therapist
  • Somerset, KY
National Provider Identifier
1962058669
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
LAKE CUMBERLAND PEDIATRIC THERAPY, LLC
Practice address
67 Jacks LN
Somerset, KY 42501-6152
Phone
(606) 425-4371
NPI assigned
Aug 18, 2019
Last updated
Aug 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Authorized official

Name
Mrs. Cynthia C Jones, PTNPI 1720484330
Title
Owner
Phone
(606) 305-1358

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

67 Jacks LN
Somerset, KY 42501-6152

Mailing address

67 Jacks LN
Somerset, KY 42501-6152
Phone (606) 425-4371

Other practice location 1

861 N Main St
Monticello, KY 42633-1539
Phone (606) 396-3532

National Provider Directory

National Provider Directory
Tax ID family
Lake Cumberland Pediatric Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

861 N Main St
Monticello, KY 42633
Phone (606) 396-3532

67 Jacks Ln
Somerset, KY 42501
Phone (606) 425-4371

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1566086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1962058669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 JACKS LN",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425016152",
            "telephone_number": "606-425-4371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 JACKS LN",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425016152",
            "telephone_number": "606-425-4371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "861 N Main St",
            "address_purpose": "LOCATION",
            "city": "Monticello",
            "state": "KY",
            "postal_code": "426331539",
            "country_code": "US",
            "telephone_number": "606-396-3532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKE CUMBERLAND PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-18",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "606-305-1358",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.