| Lake Cumberland Physician Practices, Llc | |
|
27 Imaging Dr, Suite B, Somerset, KY 42503 | |
| (606) 679-7464 | |
| (606) 678-8586 |
| Full Name | Lake Cumberland Physician Practices, Llc |
|---|---|
| Type | Facility |
| Speciality | Orthopaedic Surgery |
| Location | 27 Imaging Dr, Somerset, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811356892 | NPI | - | NPPES |
| Provider Name | Todd L Horn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093814808 PECOS PAC ID: 3173422599 Enrollment ID: I20040106000001 |
| Provider Name | Harold H Rutledge |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1184666521 PECOS PAC ID: 1850383761 Enrollment ID: I20040331001459 |
| Provider Name | Amr O El-naggar |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1033180757 PECOS PAC ID: 3577546746 Enrollment ID: I20040614000167 |
| Provider Name | Samir I Cook |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1629075296 PECOS PAC ID: 4880685007 Enrollment ID: I20040624000189 |
| Provider Name | Yasser A Nadim |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1477505634 PECOS PAC ID: 7315832581 Enrollment ID: I20040920001095 |
| Provider Name | Natarajan Mullai |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1851373096 PECOS PAC ID: 0648249078 Enrollment ID: I20041001000080 |
| Provider Name | Piyush Patel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164413159 PECOS PAC ID: 0042115404 Enrollment ID: I20051013000612 |
| Provider Name | Angela Stinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528050853 PECOS PAC ID: 7416973920 Enrollment ID: I20051024000194 |
| Provider Name | Barry White |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609879758 PECOS PAC ID: 1850369679 Enrollment ID: I20070328000053 |
| Provider Name | Anjum Iqbal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982793790 PECOS PAC ID: 4385737147 Enrollment ID: I20070910000809 |
| Provider Name | Khalid Iqbal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1447349329 PECOS PAC ID: 5294828067 Enrollment ID: I20070910000896 |
| Provider Name | Daniel Robert Yanicko |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1598731796 PECOS PAC ID: 2961504683 Enrollment ID: I20080304000250 |
| Provider Name | Tommy W Shelton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770617854 PECOS PAC ID: 9234202326 Enrollment ID: I20080723000317 |
| Provider Name | Melissa Cheng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225258130 PECOS PAC ID: 2769582816 Enrollment ID: I20081021000051 |
| Provider Name | Kenneth E Ruby |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1063419133 PECOS PAC ID: 8527123694 Enrollment ID: I20090224000764 |
| Provider Name | Randall Elliot Dalton |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1336155944 PECOS PAC ID: 8729094628 Enrollment ID: I20090504000259 |
| Provider Name | Richard J Heuer |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1497757439 PECOS PAC ID: 1850204520 Enrollment ID: I20090706000504 |
| Provider Name | Lisa E Marcum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306076443 PECOS PAC ID: 9931254174 Enrollment ID: I20090911000257 |
| Provider Name | Benjamin C Bryson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184887432 PECOS PAC ID: 5698817690 Enrollment ID: I20100128000273 |
| Provider Name | Patrick F Jenkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417921883 PECOS PAC ID: 4284762030 Enrollment ID: I20100514000525 |
| Provider Name | Sharon Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821324278 PECOS PAC ID: 8921139791 Enrollment ID: I20100623000864 |
| Provider Name | Jesse L Pace |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679779276 PECOS PAC ID: 3678649969 Enrollment ID: I20100913001044 |
| Provider Name | Magdy El Kalliny |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1275504730 PECOS PAC ID: 0143428060 Enrollment ID: I20101206000022 |
| Provider Name | Stephanie M Hutchinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154640357 PECOS PAC ID: 0143419028 Enrollment ID: I20110107000139 |
| Provider Name | Sandra Lee Braswell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700186343 PECOS PAC ID: 3971792664 Enrollment ID: I20110111000968 |
| Provider Name | Alisha J Cooley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851699060 PECOS PAC ID: 9032395413 Enrollment ID: I20110519000371 |
| Provider Name | John C Mobley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619059334 PECOS PAC ID: 6305742545 Enrollment ID: I20111230000127 |
| Provider Name | Jocelyn Elhalawany |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518215326 PECOS PAC ID: 1951550722 Enrollment ID: I20121011000429 |
| Provider Name | Brenda Jean Jobson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1831126887 PECOS PAC ID: 2860592789 Enrollment ID: I20130326000059 |
| Provider Name | Dennis J Joseph |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1336307792 PECOS PAC ID: 5193961605 Enrollment ID: I20130927000694 |
| Provider Name | Molly Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386080752 PECOS PAC ID: 7012140643 Enrollment ID: I20140505002230 |
| Provider Name | Benjamin L Stivers |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447588009 PECOS PAC ID: 1951521939 Enrollment ID: I20140926000523 |
| Provider Name | Robin Goff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710381124 PECOS PAC ID: 2062735251 Enrollment ID: I20141218002283 |
| Provider Name | Carol A Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538561618 PECOS PAC ID: 9436473519 Enrollment ID: I20150120001679 |
| Provider Name | Heidi Renae Frey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710063300 PECOS PAC ID: 2062517923 Enrollment ID: I20150413000658 |
| Provider Name | Tracie L Parrish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689063349 PECOS PAC ID: 1850612755 Enrollment ID: I20150603003116 |
| Provider Name | Leslie E. Schwindel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1720215254 PECOS PAC ID: 2062730278 Enrollment ID: I20151229001324 |
| Provider Name | Jody Coomer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962863407 PECOS PAC ID: 4880991488 Enrollment ID: I20160421000890 |
| Provider Name | Surya Kumar |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1154470466 PECOS PAC ID: 0941299689 Enrollment ID: I20160428000910 |
| Provider Name | Shawn M Acino |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1942319850 PECOS PAC ID: 3375535149 Enrollment ID: I20161017002114 |
| Provider Name | Nina Frances Booth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871029181 PECOS PAC ID: 6901170596 Enrollment ID: I20170920002501 |
| Provider Name | Jacob Dudley Coffey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194232207 PECOS PAC ID: 0244594109 Enrollment ID: I20180501002823 |
| Provider Name | Candace Lanier Mckee |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1689017360 PECOS PAC ID: 7315187804 Enrollment ID: I20180618001833 |
| Provider Name | Leslie Chambers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548786213 PECOS PAC ID: 9739436353 Enrollment ID: I20180726003443 |
| Provider Name | William Geisert |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1336415736 PECOS PAC ID: 0840417192 Enrollment ID: I20180918002184 |
| Provider Name | Patrick Gorman Shepherd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629561493 PECOS PAC ID: 6103179270 Enrollment ID: I20181019002084 |
| Provider Name | William G Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801360524 PECOS PAC ID: 9931441219 Enrollment ID: I20190507002273 |
| Provider Name | Heather Ann Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417434200 PECOS PAC ID: 5991048712 Enrollment ID: I20190520000904 |
| Provider Name | Heather Ramsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578125274 PECOS PAC ID: 1850629809 Enrollment ID: I20190828003973 |
| Provider Name | Danielle E Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699324566 PECOS PAC ID: 1052641677 Enrollment ID: I20190925000866 |
| Provider Name | Jessica Mckinney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669015103 PECOS PAC ID: 7911330261 Enrollment ID: I20191127002022 |
| Provider Name | Lana R New |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851939045 PECOS PAC ID: 2062842396 Enrollment ID: I20200428001321 |
| Provider Name | Joseph Eid |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1467894113 PECOS PAC ID: 6002058500 Enrollment ID: I20200804000669 |
| Provider Name | May Abdelhak Ghanim-moustafa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255816088 PECOS PAC ID: 8123446507 Enrollment ID: I20200916002910 |
| Provider Name | Brandi Lynee Mullins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386242998 PECOS PAC ID: 1153738372 Enrollment ID: I20210405001829 |
| Provider Name | Stacey Strunk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174141477 PECOS PAC ID: 5597174433 Enrollment ID: I20210506000394 |
| Provider Name | Ausaf Ahmed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1720439540 PECOS PAC ID: 5496041634 Enrollment ID: I20210624002109 |
| Provider Name | Michelle Lynn King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659951911 PECOS PAC ID: 9234531583 Enrollment ID: I20210709001054 |
| Provider Name | Stacey L Bowlds |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1861847394 PECOS PAC ID: 5991063745 Enrollment ID: I20210721001944 |
| Provider Name | Katie J Aaron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033792726 PECOS PAC ID: 3870997703 Enrollment ID: I20210813001904 |
| Provider Name | Courtney Cheyenne Floyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245827658 PECOS PAC ID: 3072918119 Enrollment ID: I20210826003595 |
| Provider Name | Vannessa Marie Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538822192 PECOS PAC ID: 5698165140 Enrollment ID: I20211124001295 |
| Provider Name | Elizabeth Erin Combs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063173904 PECOS PAC ID: 3274910500 Enrollment ID: I20220506000842 |
| Provider Name | Jingkun Wang |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1407387731 PECOS PAC ID: 9739431503 Enrollment ID: I20220803001868 |
| Provider Name | Charlotte Kaye Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497494512 PECOS PAC ID: 3971988056 Enrollment ID: I20220912000510 |
| Provider Name | Pennie Christine Haste |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922730605 PECOS PAC ID: 2365828670 Enrollment ID: I20221010001431 |
| Provider Name | Jacob N Rizkalla |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1134784978 PECOS PAC ID: 0042699480 Enrollment ID: I20230925002593 |
| Provider Name | Justin Hunsucker |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1568720167 PECOS PAC ID: 6709104953 Enrollment ID: I20240327002534 |
| Provider Name | Laura Zigler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033663174 PECOS PAC ID: 5890081368 Enrollment ID: I20240924001732 |
| Provider Name | Steven Cooperman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1467008383 PECOS PAC ID: 0547621112 Enrollment ID: I20241007003388 |
| Provider Name | Amanda Jo Holder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194564211 PECOS PAC ID: 2365973815 Enrollment ID: I20241008002044 |
| Provider Name | Kimberly Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407666142 PECOS PAC ID: 0749702330 Enrollment ID: I20250324003145 |
| Provider Name | Liara Patton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811750888 PECOS PAC ID: 3779006648 Enrollment ID: I20250401002366 |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Cumberland Physician Practices, Llc 330 Seven Springs Way, Brentwood, TN 37027-5098 Ph: (615) 920-7000 | Lake Cumberland Physician Practices, Llc 27 Imaging Dr, Suite B, Somerset, KY 42503 Ph: (606) 679-7464 |