NPIMap

Organization Active NPI

Lake Cumberland Physician Practices LLC

  • Family Medicine Physician
  • Somerset, KY
National Provider Identifier
1982999843
Registry record updated Sep 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LAKE CUMBERLAND PHYSICIAN PRACTICES LLC
Practice address
340 Bogle St
Suite 104
Somerset, KY 42503-2892
Phone
(606) 677-9250
Fax
(606) 677-9830
NPI assigned
Jun 17, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2017

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

Authorized official

Name
Sara Miller
Title
Director
Phone
(615) 920-7514

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

340 Bogle St
Suite 104
Somerset, KY 42503-2892

Mailing address

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7000

Other names 1

  • Somerset Family Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090504000210 KY Part B Supplier - Clinic/Group Practice 2567510464 Receives reassigned benefits from 87 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Somerset, KY; Whitley City, KY; Springfield, KY; London, KY; Russell Springs, KY; Harlan, KY

Other NPIs on the same Medicare enrollment 16

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

View all 16

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506470400000",
    "number": "1982999843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "37027",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 BOGLE ST",
            "address_2": "SUITE 104",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032892",
            "telephone_number": "606-677-9250",
            "fax_number": "606-677-9830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CUMBERLAND PHYSICIAN PRACTICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-17",
        "last_updated": "2017-09-27",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-920-7514"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Somerset Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 27, 2017; 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.