LAKE CUMBERLAND PHYSICIAN PRACTICES, LLC (NPI# 1164832531) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164832531 |
| Entity Type | Organization |
| Organization Name | LAKE CUMBERLAND PHYSICIAN PRACTICES, LLC |
| Other Organization Name | RUSSELL COUNTY MEDICAL ASSOCIATES |
| Practice Address |
72 Joe T Petty Dr Russell Springs KY 42642-8533 |
| Mailing Address |
Po Box 719 Somerset KY 42502-0719 |
| Practice Telephone | 2708667771 |
| Practice Fax Number | 2708667774 |
| Mailing Telephone | 2708667771 |
| Mailing Fax Number | 2708667774 |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2017-09-27 |
| Authorized Official Name | SARA MILLER (DIRECTOR) |
| Authorized Official Telephone | 6159207514 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Russell County Medical Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811356892 | Lake Cumberland Physician Practices, LLC | Nurse Practitioner | 27 Imaging Dr, Suite B, Somerset, KY 42503 | 2016-02-18 |
| 1982073813 | Lake Cumberland Physician Practices, LLC | Physician Assistant | 30 Medpark Square, Suite 1, Somerset, KY 42503-1709 | 2015-09-22 |
| 1124441274 | Lake Cumberland Physician Practices, LLC | Internal Medicine | 401 Bogle St, Suite 101, Somerset, KY 42503-3823 | 2014-01-27 |
| 1538594668 | Lake Cumberland Physician Practices, LLC | Internal Medicine | 349 Bogle St, Suite A, Somerset, KY 42503-2895 | 2013-09-09 |
| 1730489840 | Lake Cumberland Physician Practices, LLC | Nurse Practitioner | 305 Langdon Street, Suite P, Somerset, KY 42503 | 2010-10-25 |
| 1841424611 | Lake Cumberland Physician Practices, LLC | Surgery | 353 Bogle St, Suite B, Somerset, KY 42503-2888 | 2009-05-08 |
| 1790924785 | Lake Cumberland Physician Practices, LLC | Nurse Practitioner | 143a Bogle Office Park Dr, Somerset, KY 42503-2810 | 2009-02-13 |
| 1053550046 | Lake Cumberland Physician Practices, LLC | Physician Assistant | 120 Tradepark Dr, Suite B, Somerset, KY 42503-3454 | 2009-02-13 |
| 1285832808 | Lake Cumberland Physician Practices, LLC | General Practice | 350 Hospital Way Ste 100, Somerset, KY 42503-1872 | 2007-07-05 |
| Street Address |
72 JOE T PETTY DR |
| City | RUSSELL SPRINGS |
| State | KY |
| Zip Code | 42642-8533 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447298666 | James Medical Equipment, Ltd. | Durable Medical Equipment & Medical Supplies | 72 Joe T Petty Dr, Russell Springs, KY 42642-8533 | 2006-06-02 |
| 1508196262 | Southern Ky Medical Associates | Clinical Nurse Specialist | 72 Joe T Petty Dr, Russell Springs, KY 42718 | 2009-12-31 |
| 1194874859 | Jamed Medical Equipment, Ltd | Durable Medical Equipment & Medical Supplies | 72 Joe T Petty Dr, Russell Springs, KY 42642-8533 | 2007-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730645490 | New Hope Counseling Services L.l.c | Psychologist | 330 Roy Drive, Russell Springs, KY 42642 | 2019-02-18 |
| 1629459912 | Ephraim Mcdowell Health Resources,inc | Physician Assistant | 92 Jt Petty Drive, Ste 300, Russell Springs, KY 42642 | 2015-06-12 |
| 1619397775 | Terri Susanne Jones Watkins Odpsc | Optometrist | 24 Caden Way, Suite 2, Russell Springs, KY 42642 | 2014-04-16 |
| 1548512247 | Charles Lenwood Gore | Pharmacist | 1372 Snow Rd, Russell Springs, KY 42642 | 2012-10-05 |
| 1407125016 | Avante Garde Health Centers, LLC | Clinic/Center | 72 Joe T Pettey Dr, Suite B, Russell Springs, KY 42642 | 2011-12-28 |
| 1821392515 | Southern Kentucky Medical Associates, Psc | Nurse Practitioner | 72 Joe T. Pettey Dr, Russell Springs, KY 42642 | 2011-01-10 |
| 1801106620 | Premiertox, Inc. | Clinical Medical Laboratory | 2431 Lakeway Drive, Suite A1, Russell Springs, KY 42642 | 2010-10-14 |
| 1639404593 | Rx Drug Monitoring Laboratory, LLC | Clinical Medical Laboratory | 660 Lakeway Drive, Suite A, Russell Springs, KY 42642 | 2009-10-11 |
| 1902079023 | Russell County Hospital | Specialist | 92 Jt Pettey Drive, Russell Springs, KY 42642 | 2008-04-09 |
| 1225242779 | Independent Speech Inc | Physical Therapist | 1831 Old Clear Springs Rd, Russell Springs, KY 42642 | 2007-05-10 |
| Find all providers in zip 42642 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881679496 | John D Kilgallin | Family Medicine | 404 Steve Dr, Russell Springs, KY 42642-4622 | 2005-12-07 |
| 1922414481 | Leann Dalton Cooper | Family Medicine | 124 Dowell Rd, Russell Springs, KY 42642 | 2014-07-05 |
| 1821276130 | Liesel C Grentz | Family Medicine | 124 Dowell Rd, Russell Springs, KY 42642-4278 | 2008-02-08 |
| 1356443477 | John Kilgallin M.d. | Family Medicine | 124 Dowell Rd, Russell Springs, KY 42642-4278 | 2006-09-01 |
| 1235188772 | Richard Stayton Miles | Family Medicine | 124 Dowell Rd, Russell Springs, KY 42642-4278 | 2006-05-10 |
| 1700857414 | Miles Kenton Gibson | Family Medicine | 92 Joe T Petty Dr, Suite 300, Russell Springs, KY 42642-8543 | 2006-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890431 | Alishia Gayle Euler | Family Medicine | 730 Della Dr, Lexington, KY 40504-3610 | 2020-11-01 |
| 1306443908 | Complete Wellness Inc | Family Medicine | 25 Joshua Lane, Hawesville, KY 42348 | 2020-10-06 |
| 1811503410 | Angela Coffman | Family Medicine | 1000 Thompson Dr, Beaver Dam, KY 42320-9152 | 2020-09-18 |
| 1871107375 | West Towne Clinical Services Pllc | Family Medicine | 2755 W Park Dr Ste 1, Paducah, KY 42001-9058 | 2020-09-02 |
| 1528670981 | Visium Healthlink LLC | Family Medicine | 507 Avawam Dr, Richmond, KY 40475-9195 | 2020-08-18 |
| 1114535911 | Lea Anne Bunch | Family Medicine | 12080 S Dixie Hwy, Sonora, KY 42776-9739 | 2020-07-17 |
| 1952929689 | Yasir LLC | Family Medicine | 103 Financial Pl Ste 300, Elizabethtown, KY 42701-4470 | 2020-07-09 |
| 1578188637 | Megan Elizabeth Burke | Family Medicine | 641 Zag Rd, West Liberty, KY 41472-7625 | 2020-06-14 |
| 1679197529 | Kentucky Mountain Interventional and Infusion Therapies, LLC. | Family Medicine | 101 Hibbard St Ste 200, Pikeville, KY 41501-1788 | 2020-06-05 |
| 1548883960 | Proactive Md Ky Psc | Family Medicine | 4340 Crittenden Dr, Louisville, KY 40209-1600 | 2020-05-20 |
| Find all providers with the same taxonomy | ||||
| City | RUSSELL SPRINGS |
| Zip Code | 42642 |
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| 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.