PINELAKE PHYSICIAN PRACTICE, LLC (NPI# 1942535281) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942535281 |
| Entity Type | Organization |
| Organization Name | PINELAKE PHYSICIAN PRACTICE, LLC |
| Other Organization Name | MAYFIELD ORTHOPEDIC ASSOCIATES |
| Practice Address |
1111 Medical Center Cir Mayfield KY 42066-1194 |
| Mailing Address |
1029 Medical Center Cir Mayfield KY 42066-1189 |
| Practice Telephone | 2702514070 |
| Practice Fax Number | 2702514074 |
| Mailing Telephone | 2702514547 |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2010-11-23 |
| Authorized Official Name | TIMOTHY VAUGHN (VICE PRESIDENT) |
| Authorized Official Telephone | 6155651513 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Mayfield Orthopedic Associates | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437623337 | Pinelake Physician Practice, LLC | Clinic/Center | 101 Main St, Fulton, KY 42041-1601 | 2019-01-14 |
| 1972738839 | Pinelake Physician Practice, LLC | Surgery | 1111 Medical Center Cir, Mayfield, KY 42066-1194 | 2009-05-21 |
| 1295960532 | Pinelake Physician Practice, LLC | Family Medicine | 1111 Medical Center Cir, Mayfield, KY 42066-1194 | 2009-05-15 |
| 1861563439 | Pinelake Physician Practice, LLC | Family Medicine | 2003 S 7th St, Hickman, KY 42050-1841 | 2006-11-13 |
| Street Address |
1111 MEDICAL CENTER CIR |
| City | MAYFIELD |
| State | KY |
| Zip Code | 42066-1194 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538162458 | Joseph C. Slaughter | Internal Medicine | 1111 Medical Center Cir, Mayfield, KY 42066-1194 | 2005-05-24 |
| 1992254288 | Jackson Purchase Pulmonary Medicine Pllc | Nurse Practitioner | 1111 Medical Center Cir, Mayfield, KY 42066-1194 | 2016-09-27 |
| 1114383981 | Jennifer L Carrico | Nurse Practitioner | 1111 Medical Center Cir, Mayfield, KY 42066-1194 | 2016-01-11 |
| 1902189491 | Michelle Ann Jewell | Nurse Practitioner | 1111 Medical Center Cir, Mayfield, KY 42066 | 2011-09-21 |
| 1912216532 | Pinelake Physician Practice LLC | Family Medicine | 1111 Medical Center Cir, Mayfield, KY 42066-1194 | 2010-09-30 |
| 1104147891 | Siddharth Patel | Pediatrics | 1111 Medical Center Cir, Mayfield, KY 42066-1194 | 2010-06-16 |
| 1255650479 | Pinelake Physician Practice LLC | Otolaryngology | 1111 Medical Center Cir, Mayfield, KY 42066-1194 | 2010-05-27 |
| 1346478344 | Pooja Parshotam Makhija | Pediatrics | 1111 Medical Center Cir, Mayfield, KY 42066-1194 | 2009-06-29 |
| 1972738839 | Pinelake Physician Practice, LLC | Surgery | 1111 Medical Center Cir, Mayfield, KY 42066-1194 | 2009-05-21 |
| 1295960532 | Pinelake Physician Practice, LLC | Family Medicine | 1111 Medical Center Cir, Mayfield, KY 42066-1194 | 2009-05-15 |
| Find all providers in the same location | ||||
| 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 | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881927770 | Puneet Bhatia | Orthopaedic Surgery | 1029 Medical Center Cir, Suite 200, Mayfield, KY 42066-1189 | 2009-09-10 |
| 1770782104 | Purchase Regional Orthopaedics Psc | Orthopaedic Surgery | 1029 Medical Center Cir, Suite 406, Mayfield, KY 42066-1189 | 2007-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790322170 | Louisville Spine Institute LLC | Orthopaedic Surgery | 6500 Glenridge Park Pl Ste 9, Louisville, KY 40222-3450 | 2019-12-05 |
| 1114584612 | Injury Rehab Center LLC | Orthopaedic Surgery | 611 W Poplar St Ste C12, Elizabethtown, KY 42701-2477 | 2019-05-21 |
| 1679077531 | Travis Parkulo | Orthopaedic Surgery | 550 South Jackson Street 1st Floor Acb, Louisville, KY 40292-1219 | 2018-03-23 |
| 1588168611 | Boshen Liu | Orthopaedic Surgery | 740 S Limestone Room K403, Lexington, KY 40536-0293 | 2018-03-22 |
| 1013417419 | Cumberland Foot and Ankle Centers | Orthopaedic Surgery | 509 Hampton Way, Richmond, KY 40475-8680 | 2018-02-13 |
| 1598265993 | Cumberland Foot & Ankle Centers | Orthopaedic Surgery | 141 Prosperous Pl Ste 22a, Lexington, KY 40509-1854 | 2018-02-13 |
| 1053819904 | Cumberland Foot and Ankle Centers | Orthopaedic Surgery | 1850 Westen Street, Bowling Green, KY 42104 | 2018-01-25 |
| 1881107886 | Bellefonte Physician Services, Inc. | Orthopaedic Surgery | 1100 St. Christopher Dr., Ashland, KY 41101-7055 | 2017-11-13 |
| 1073034385 | Cumberland Foot and Ankle Centers | Orthopaedic Surgery | 115 Tradepark Dr Ste B, Somerset, KY 42503-3428 | 2017-06-28 |
| 1437679990 | Cumberland Foot and Ankle Centers | Orthopaedic Surgery | 1830 Destiny Ln Ste 110, Bowling Green, KY 42104-1088 | 2017-06-26 |
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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.