PINELAKE PHYSICIAN PRACTICES LLC NPI 1336314442

NPI Information

  • NPI: 1336314442
  • Provider Name: PINELAKE PHYSICIAN PRACTICES LLC
  • Classification: Internal Medicine - 207RN0300X
  • Specialization: Nephrology
  • Entity Type: Organization
  • Doing Business As: JACKSON PURCHASE NEPHROLOGY
  • CLIA Number: 18D2300365
  • Address: 1029 MEDICAL CENTER CIR
    SUITE 200 A
    MAYFIELD, KY
    ZIP 42066
  • Phone: (270) 251-4545

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NPI Details

PINELAKE PHYSICIAN PRACTICES LLC is a nephrology internal medicine in Mayfield, KY. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. PINELAKE PHYSICIAN PRACTICES LLC NPI is 1336314442. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Jackson Purchase Nephrology.

The provider's business location address is:

1029 MEDICAL CENTER CIR
SUITE 200 A
MAYFIELD, KY
ZIP 42066-189
Phone: (270) 251-4545
Fax: (270) 251-4546

The provider's authorized official is Thomas Weiss .
The authorized official title is Division President and has the following contact phone number (615) 375-8500.

The CLIA number assigned to this NPI record is 18D2300365 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/29/2008 and was last updated on 4/29/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RN0300XInternal MedicineNephrologyYes

What is NPI?

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This page was last updated on: 11/21/2025

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