| Lake Cumberland Pediatrics Pllc | |
|
268 Rolling Hills Blvd. Monticello KY 42633-9004 | |
| (606) 753-0293 | |
| (606) 753-0291 |
| Full Name | Lake Cumberland Pediatrics Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 268 Rolling Hills Blvd., Monticello, Kentucky |
| Authorized Official Name and Position | Joseph Clay Brown (OWNER) |
| Authorized Official Contact | 6067530293 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Cumberland Pediatrics Pllc Po Box 1737 N/a Monticello KY 42633-4737 Ph: (606) 753-0293 | Lake Cumberland Pediatrics Pllc 268 Rolling Hills Blvd. Monticello KY 42633-9004 Ph: (606) 753-0293 |
| NPI Number | 1518406859 |
|---|---|
| Provider Enumeration Date | 02/20/2017 |
| Last Update Date | 05/27/2022 |
| Medicare PECOS PAC ID | 3375828379 |
|---|---|
| Medicare Enrollment ID | O20170313002409 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518406859 | NPI | - | NPPES |
| 900327 | Other | KY | RHC LIC |
| 18-8969 | Other | KY | MEDICARE PART A |
| 7100447120 | Medicaid | KY | |
| 7100462460 | Other | KY | NP GROUP MEDICAID |
| Provider Name | Joseph Clay Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619295540 PECOS PAC ID: 5395960298 Enrollment ID: I20140709001933 |
| Provider Name | Danielle Choate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962891689 PECOS PAC ID: 0648599530 Enrollment ID: I20150427001295 |
| Provider Name | Amy Doris Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942700976 PECOS PAC ID: 0941561922 Enrollment ID: I20180308001115 |
| Provider Name | Jatessia Marcum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245873090 PECOS PAC ID: 2264860527 Enrollment ID: I20200319001850 |
| Provider Name | Ashleigh Renee Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508477209 PECOS PAC ID: 0941627327 Enrollment ID: I20200831002138 |
| Provider Name | Sojnia I Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457968406 PECOS PAC ID: 5395156590 Enrollment ID: I20201119000593 |
| Provider Name | Amber D Ball |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598345738 PECOS PAC ID: 8527477611 Enrollment ID: I20210430000875 |
| Provider Name | Jessica Bertram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336833490 PECOS PAC ID: 2365802501 Enrollment ID: I20230719001199 |
Faith Dental Of Monticello Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1225 N Main St, Monticello, KY 42633 Phone: 606-340-0740 Fax: 606-340-0742 | |
Community Care Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 126 Franklin Drive, Monticello, KY 42633 Phone: 606-685-6131 Fax: 606-685-6179 | |
Phillips Pratt & Mcfarland Psc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1 S Creek Dr Ste 102, Monticello, KY 42633 Phone: 606-348-3365 | |
Women's Care Of Lake Cumberland Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 39 Jim Hill Service Rd, Monticello, KY 42633 Phone: 606-678-0705 Fax: 606-678-2807 | |
Monticello Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 S Creek Dr Ste 102, Monticello, KY 42633 Phone: 606-348-3365 Fax: 606-348-8496 | |
Community Based Interventions Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 80 Rolling Hills Blvd, Monticello, KY 42633 Phone: 606-343-0216 Fax: 606-343-0224 | |
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