PINELAKE PHYSICIAN PRACTICE LLC (NPI# 1679061071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679061071 |
| Entity Type | Organization |
| Organization Name | PINELAKE PHYSICIAN PRACTICE LLC |
| Other Organization Name | JACKSON PURCHASE PRIMARY CARE WILLIAMS CLINIC |
| Practice Address |
110 S 9th St Mayfield KY 42066-2208 |
| Mailing Address |
330 Seven Springs Way Brentwood TN 37027-5098 |
| Practice Telephone | 2702477795 |
| Practice Fax Number | 2702472602 |
| Mailing Telephone | 6159207905 |
| Mailing Fax Number | 6159208935 |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2018-05-01 |
| Authorized Official Name | SARA MILLER (DIRECTOR) |
| Authorized Official Telephone | 6152029581 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Jackson Purchase Primary Care Williams Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922645134 | Pinelake Physician Practice LLC | Clinic/Center | 417 S 6th St, Mayfield, KY 42066-2311 | 2019-12-06 |
| 1275178089 | Pinelake Physician Practice LLC | Clinic/Center | 417 S 6th St, Mayfield, KY 42066-2311 | 2019-11-15 |
| 1205494085 | Pinelake Physician Practice LLC | Clinic/Center | 2003 S 7th St, Hickman, KY 42050-1841 | 2019-06-05 |
| 1437614633 | Pinelake Physician Practice LLC | Nurse Practitioner | 106 W Clay St, Clinton, KY 42031-1317 | 2019-02-01 |
| 1912216532 | Pinelake Physician Practice LLC | Family Medicine | 1111 Medical Center Cir, Mayfield, KY 42066-1194 | 2010-09-30 |
| 1255650479 | Pinelake Physician Practice LLC | Otolaryngology | 1111 Medical Center Cir, Mayfield, KY 42066-1194 | 2010-05-27 |
| 1891939690 | Pinelake Physician Practice LLC | Internal Medicine | 1029 Medical Center Cir, Mayfield, KY 42066-1189 | 2009-04-23 |
| Street Address |
110 S 9TH ST |
| City | MAYFIELD |
| State | KY |
| Zip Code | 42066-2208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952304891 | Patricia Mary Williams | Family Medicine | 110 S 9th St, Mayfield, KY 42066-2208 | 2005-05-24 |
| 1710591656 | Williams Medical Practice LLC | Family Medicine | 110 S 9th St, Mayfield, KY 42066-2208 | 2020-09-08 |
| 1841650975 | Williams Nurse Practitioner Group | Nurse Practitioner | 110 S 9th St, Mayfield, KY 42066-2208 | 2016-03-02 |
| 1609104546 | Lela Kristine Cole | Nurse Practitioner | 110 S 9th St, Mayfield, KY 42066-2208 | 2009-12-04 |
| 1366544827 | Wayne E. Williams | Family Medicine | 110 S 9th St, Mayfield, KY 42066-2208 | 2006-09-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760031959 | Snh Derby Tenant LLC | Assisted Living Facility | 1517 West Broadway Street, Mayfield, KY 42066 | 2019-09-10 |
| 1033674254 | Mind, Body, Soul, LLC | Clinic/Center | 1325 Us 45 S, Suite C, Mayfield, KY 42066 | 2019-02-01 |
| 1699288936 | Kimberly Kaye Gooch | Developmental Therapist | 3907 State Route 303, Mayfield, KY 42066 | 2017-11-08 |
| 1538604657 | Courtney L Coleman | Nurse Practitioner | 1029 Medical Center Cir Ste 200, Mayfield, KY 42066 | 2016-12-28 |
| 1659814721 | Bertha Workman | Voluntary or Charitable | 331 South 7th Street, Mayfield, KY 42066 | 2016-11-22 |
| 1699174052 | Laura Dassing | Counselor | 1325 Hwy 45 N, Mayfield, KY 42066 | 2014-08-21 |
| 1275947905 | Wkda Services LLC | Community/Behavioral Health | 1325 U S Hwy 45n, Mayfield, KY 42066 | 2014-06-20 |
| 1538594247 | Young Healthcare LLC | Chiropractor | 1011 Paris Road #341, Mayfield, KY 42066 | 2013-09-12 |
| 1811335649 | Donald Bennett Dowdy | Dentist | 236 N. 6th St., Mayfield, KY 42066 | 2013-06-14 |
| 1578822623 | Wanda Bingham Marshall | Counselor | 325 South 8th Street, West Kentucky Counseling Center, Mayfield, KY 42066 | 2012-05-10 |
| Find all providers in zip 42066 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922645134 | Pinelake Physician Practice LLC | Clinic/Center | 417 S 6th St, Mayfield, KY 42066-2311 | 2019-12-06 |
| 1275178089 | Pinelake Physician Practice LLC | Clinic/Center | 417 S 6th St, Mayfield, KY 42066-2311 | 2019-11-15 |
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|---|---|---|---|---|
| 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 |
| Find all providers with the same taxonomy | ||||
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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.