LAKE CUMBERLAND PEDIATRICS PLLC


Address: 1215 N Main St Ste 2, N/a, Monticello, KY 42633
Phone: 6067530293

LAKE CUMBERLAND PEDIATRICS PLLC (NPI# 1518406859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1518406859
Entity Type Organization
Organization Name LAKE CUMBERLAND PEDIATRICS PLLC
Practice Address 1215 N Main St Ste 2
N/a
Monticello
KY 42633
Mailing Address Po Box 1737
N/a
Monticello
KY 42633-4737
Practice Telephone 6067530293
Practice Fax Number 6067530291
Mailing Telephone 6067530293
Mailing Fax Number 6067530291
Enumeration Date 2017-02-20
Last Update Date 2018-06-04
Authorized Official Name JOSEPH CLAY BROWN (OWNER)
Authorized Official Telephone 6067530293
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207R00000X Internal Medicine Allopathic & Osteopathic Physicians
N 208000000X Pediatrics Allopathic & Osteopathic Physicians
N 363LF0000X Nurse Practitioner
Specialization: Family
Physician Assistants & Advanced Practice Nursing Providers
Y 261QR1300X Clinic/Center
Specialization: Rural Health
900327 KY Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
KY MEDICARE PART A 18-8969 01
KY NP GROUP MEDICAID 7100462460 01
KY 7100447120 05
KY RHC LIC 900327 01

Office Location

Street Address 1215 N MAIN ST STE 2
N/A
City MONTICELLO
State KY
Zip Code 42633

Providers in the same location

NPI Name Taxonomy Address Enumeration
1295196137 Miranda Tompkins Nurse Practitioner 1215 N Main St Ste 2, Monticello, KY 42633-2900 2016-03-18
1851867139 Emilee Burton Greenwood Clinic/Center 1215 N Main St Ste 2, Monticello, KY 42633-2900 2018-10-15
1942700976 Amy Doris Edwards Nurse Practitioner 1215 N Main St Ste 2, Monticello, KY 42633-2900 2018-02-16

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1457963431 Morgan Dishman Pharmacist 126 Franklin Dr, Monticello, KY 42633 2020-08-20
1942847686 Burgess Drug Store Inc. Pharmacy 1 S. Creek Dr., Ste. #122, Monticello, KY 42633 2019-12-02
1639729460 Lake Cumberland Therapy Center, Inc. Developmental Therapist 153 High Street, Monticello, KY 42633 2019-09-13
1053964965 Faith Healthcare Inc Nurse Practitioner 126 Franklin Drive, Monticello, KY 42633 2019-07-19
1669936621 Alisa D Wallace Case Manager/Care Coordinator 803 Columbia Ave, Monticello, KY 42633 2019-01-24
1194232207 Jacob Dudley Coffey Nurse Practitioner 1 S Creek Dr Ste 102606, Monticello, KY 42633 2018-01-10
1245581578 Joleen Nyesa Levering Pharmacist 1078 North Main Streeet, Monticello, KY 42633 2012-09-26
1194085977 Steven M Tallent II Dentist 1225 N. Main St., Brummett Cosmetic and Family Dentistry, Monticello, KY 42633 2012-05-25
1245376243 Diagnostic Radiology of London Specialist 1455 E Hwy 90 By-pass Unit #4, Monticello, KY 42633 2007-01-29
1639241433 Hicks Enterprises of Monticello, LLC Nursing Facility/Intermediate Care Facility 1801 W. Hwy. 90 By-pass, Monticello, KY 42633 2006-11-15
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Taxonomy Information

Taxonomy Code 261QR1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rural Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1043716525 Mmc Rural Health Clinics, Pllc Clinic/Center 733 Roberts Drive, Monticello, AR 71655 2018-04-03
1245289172 Southwest Mississippi Regional Medical Center Clinic/Center 1167 E Broad St, Monticello, MS 39654-7682 2006-05-08
1851867139 Emilee Burton Greenwood Clinic/Center 1215 N Main St Ste 2, Monticello, KY 42633-2900 2018-10-15
1558527259 Kirby Medical Center Clinic/Center 1000 Medical Center Dr, Monticello, IL 61856-2116 2008-08-01
1700955317 Mercy Physician Associates, Inc Clinic/Center 619 S Main St, Monticello, IA 52310-1733 2006-11-07

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1669072757 Arh Mary Breckinridge Health Services, Inc. Clinic/Center 302 Walnut Street, Pineville, KY 40977 2020-10-28
1316553167 Flaget Healthcare Inc Clinic/Center 2387 Main St, Willisburg, KY 40078-8102 2020-09-17
1710590880 Flaget Healthcare, Inc Clinic/Center 4359 Shepherdsville Road, Ste 255, Bardstown, KY 40004 2020-08-28
1649881335 Emerald Therapy Center, LLC Clinic/Center 111 Poplar St, Murray, KY 42071-2571 2020-08-14
1407472319 Family Health Care Associates 7 Limited Liability Company Clinic/Center 422 N Highway 27, Whitley City, KY 42653 2020-06-17
1154950699 Family Health Care Associates 6 Limited Liability Company Clinic/Center 8070 Us Highway 60 W, Lewisport, KY 42351-7087 2020-04-06
1568098838 Appalachian Regional Healthcare, Inc Clinic/Center 186 Breanna Blvd, Suite 100, Salyersville, KY 41465-7525 2020-03-19
1780217794 Family Health Care Associates 5 Limited Liability Company Clinic/Center 74 H&b Partin Lane, Pineville, KY 40977 2020-02-18
1023649514 Memorial Hospital Inc Clinic/Center 485 Memorial Dr Ste 1, Manchester, KY 40962-9111 2020-02-03
1265072946 Baptist Health Medical Group Inc Clinic/Center 800 Hospital Dr Fl 2, Madisonville, KY 42431-1658 2020-01-10
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Competitor

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City MONTICELLO
Zip Code 42633

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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