Pinelake Physician Practice, LLC
NPI 1861563439 · Internal Medicine Physician · Mayfield, KY
Enrolled with Medicare as Dme Supplier - Physician - Podiatry · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Pinelake Physician Practice, LLC is a Internal Medicine Physician organization in Mayfield, KY (NPI 1861563439).
Provider details
- NPI number
- 1861563439
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Charlotte Lawrence, Secretary(615) 920-7000
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
Suppliers
- Cardiovascular Disease Physician207RC0000X
Allopathic & Osteopathic Physicians
- Orthopaedic Surgery Physician207X00000X
Allopathic & Osteopathic Physicians
- Family Medicine Physician207Q00000X
Allopathic & Osteopathic Physicians
- Facial Plastic Surgery Physician207YS0123X
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
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 Podiatry
Additional practice locations (2)
- 101 Main StFulton, KY 42041-1601Phone: (270) 472-5245Fax: (270) 472-5249
- 2003 S 7th StHickman, KY 42050-1841
Registry dates
- Enumerated
- 2006-11-13
- Last updated
- 2026-01-07
- Certified
- 2026-01-07
Frequently asked questions
- What is Pinelake Physician Practice, LLC's NPI number?
- Pinelake Physician Practice, LLC's National Provider Identifier (NPI) is 1861563439, 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 Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Pinelake Physician Practice, LLC located?
- Pinelake Physician Practice, LLC's practice location on file with NPPES is 1029 Medical Center Cir, Mayfield, KY 42066-1189.
- 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) 251-4590.
- Does Pinelake Physician Practice, LLC accept Medicare?
- Pinelake Physician Practice, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- 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 (1861563439) is active in the NPPES registry as of the last update on 2026-01-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.