NPIMap

Organization Active NPI

Cumberland Foot and Ankle Center

  • Foot & Ankle Surgery Podiatrist
  • Corbin, KY
National Provider Identifier
1962718155
Registry record updated Aug 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
CUMBERLAND FOOT AND ANKLE CENTER
Practice address
1007 Cumberland Falls Hwy
Corbin, KY 40701-2714
Phone
(606) 258-8637
Fax
(606) 523-4368
NPI assigned
Aug 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2010

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

Authorized official

Name
Jonathan E Moore, DPM
Title
Owner/Podiatrist
Phone
(606) 679-2773

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

1007 Cumberland Falls Hwy
Corbin, KY 40701-2714

Mailing address

117 Tradepark Dr
Somerset, KY 42503-3428
Phone (606) 679-2773

Other identifiers 1

IdentifierTypeStateIssuer
90005091MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322000214 KY Part B Supplier - Clinic/Group Practice 4385535319 Receives reassigned benefits from 24 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bowling Green, KY; Somerset, KY; Russell Springs, KY; Richmond, KY; Mount Vernon, KY; Monticello, KY; Manchester, KY; London, KY…

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Cumberland Foot and Ankle Centers13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1282694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282694400000",
    "number": "1962718155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 TRADEPARK DR",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425033428",
            "telephone_number": "606-679-2773",
            "fax_number": "606-679-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 CUMBERLAND FALLS HWY",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012714",
            "telephone_number": "606-258-8637",
            "fax_number": "606-523-4368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND FOOT AND ANKLE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-25",
        "last_updated": "2010-08-25",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/PODIATRIST",
        "authorized_official_telephone_number": "606-679-2773",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90005091",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; 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.