LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC. (NPI# 1578549184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578549184 |
| Entity Type | Organization |
| Organization Name | LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC. |
| Other Organization Name | GRAND LAKES CLINIC |
| Practice Address |
1860 Jh Obryan Ave Grand Rivers KY 42045-9049 |
| Mailing Address |
131 Hospital Dr Salem KY 42078-8043 |
| Practice Telephone | 7036282462 |
| Practice Fax Number | 2703629757 |
| Mailing Telephone | 2709882299 |
| Mailing Fax Number | 2709883900 |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2020-11-02 |
| Authorized Official Name | MR. MARK A EDWARDS (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2709882299 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
9000135 | KY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | BC/BS | 000000072411 | 01 |
| KY | 3500140300 | 05 |
| Other Name | Type Code |
|---|---|
| Grand Lakes Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326691486 | Livingston Hospital and Healthcare Services, Inc. | Clinic/Center | 117 E Main St, Salem, KY 42078-9998 | 2019-07-18 |
| 1245654094 | Livingston Hospital and Healthcare Services, Inc. | Nurse Practitioner | 131 Hospital Dr, Salem, KY 42078-8043 | 2014-02-14 |
| 1669612008 | Livingston Hospital and Healthcare Services, Inc. | Clinic/Center | 1860 J.h. O'bryan Ave., Grand Rivers, KY 42045 | 2009-02-25 |
| 1386859908 | Livingston Hospital and Healthcare Services, Inc. | Nurse Practitioner | 209 W Main St, Eddyville, KY 42038-7752 | 2007-05-14 |
| 1427034172 | Livingston Hospital and Healthcare Services, Inc. | Nurse Anesthetist, Certified Registered | 131 Hospital Dr, Salem, KY 42078-8043 | 2005-12-15 |
| 1750367413 | Livingston Hospital and Healthcare Services, Inc. | Emergency Medicine | 131 Hospital Dr, Salem, KY 42078-8043 | 2005-12-15 |
| 1588640254 | Livingston Hospital and Healthcare Services, Inc. | General Acute Care Hospital | 131 Hospital Dr, Salem, KY 42078-8043 | 2005-12-15 |
| 1730165416 | Livingston Hospital and Healthcare Services, Inc. | General Acute Care Hospital | 131 Hospital Dr, Salem, KY 42078-8043 | 2005-12-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LIVINGSTON HOSPITAL AND HEALTHCARE SERVICES, INC. | 131 Hospital Dr, Salem, KY 42078-8043 |
| Street Address |
1860 JH OBRYAN AVE |
| City | GRAND RIVERS |
| State | KY |
| Zip Code | 42045-9049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003291360 | Jeanie Nicole Doom | Nurse Practitioner | 1860 Jh Obryan Ave, Grand Rivers, KY 42045-9049 | 2015-07-28 |
| 1003892548 | Khai C Truong | Family Medicine | 1860 Jh Obryan Ave, Grand Rivers, KY 42045-9049 | 2005-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700191228 | Lee Ann Grainger Keller | Registered Nurse | 1860 J H O'bryan Ave, Grand Rivers, KY 42045 | 2010-08-09 |
| 1356429542 | Ginkgo Garden Inc | Clinic/Center | 462 Barkley Dr, Grand Rivers, KY 42045 | 2006-11-02 |
| 1336183524 | Terry L Calhoun | Family Medicine | 1860 J.h. O'bryan Ave., Grand Rivers, KY 42045 | 2006-06-16 |
| 1669612008 | Livingston Hospital and Healthcare Services, Inc. | Clinic/Center | 1860 J.h. O'bryan Ave., Grand Rivers, KY 42045 | 2009-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700191228 | Lee Ann Grainger Keller | Registered Nurse | 1860 J H O'bryan Ave, Grand Rivers, KY 42045 | 2010-08-09 |
| 1356429542 | Ginkgo Garden Inc | Clinic/Center | 462 Barkley Dr, Grand Rivers, KY 42045 | 2006-11-02 |
| 1336183524 | Terry L Calhoun | Family Medicine | 1860 J.h. O'bryan Ave., Grand Rivers, KY 42045 | 2006-06-16 |
| 1669612008 | Livingston Hospital and Healthcare Services, Inc. | Clinic/Center | 1860 J.h. O'bryan Ave., Grand Rivers, KY 42045 | 2009-02-25 |
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 1710590880 | Flaget Healthcare, Inc | Clinic/Center | 4359 Shepherdsville Road, Ste 255, Bardstown, KY 40004 | 2020-08-28 |
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| 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 |
| Find all providers with the same taxonomy | ||||
| City | GRAND RIVERS |
| Zip Code | 42045 |
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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.