Pinelake Physician Practice LLC
NPI 1093609612 · Rural Health Clinic/Center · Mayfield, KY
Pinelake Physician Practice LLC is a Rural Health Clinic/Center organization in Mayfield, KY (NPI 1093609612).
Provider details
- NPI number
- 1093609612
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Charlotte Lawrence, Secretary(615) 920-7000
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Jackson Purchase Primary Care - Southside Clinic
Registry dates
- Enumerated
- 2025-06-06
- Last updated
- 2025-06-06
- Certified
- 2025-06-06
Frequently asked questions
- What is Pinelake Physician Practice LLC's NPI number?
- Pinelake Physician Practice LLC's National Provider Identifier (NPI) is 1093609612, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pinelake Physician Practice LLC?
- Pinelake Physician Practice LLC is classified in the NPPES registry as Rural Health Clinic/Center (Ambulatory Health Care Facilities).
- Where is Pinelake Physician Practice LLC located?
- Pinelake Physician Practice LLC's practice location on file with NPPES is 1206 Paris Rd Ste B, Mayfield, KY 42066-4989.
- What is Pinelake Physician Practice LLC's phone number?
- The practice phone number listed in the NPPES registry for Pinelake Physician Practice LLC is (270) 804-7160.
- Who is the authorized official for Pinelake Physician Practice LLC?
- The authorized official listed on Pinelake Physician Practice LLC's NPPES record is Charlotte Lawrence, Secretary. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pinelake Physician Practice LLC's NPI active?
- Yes — Pinelake Physician Practice LLC's NPI (1093609612) is active in the NPPES registry as of the last update on 2025-06-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.