PINELAKE PHYSICIAN PRACTICE LLC NPI 1861563439

NPI Information

  • NPI: 1861563439
  • Provider Name: PINELAKE PHYSICIAN PRACTICE, LLC
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Organization
  • Address: 2003 S 7TH ST
    HICKMAN, KY
    ZIP 42050
  • Phone:

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NPI Details

PINELAKE PHYSICIAN PRACTICE, LLC is an internal medicine in Hickman, KY. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. PINELAKE PHYSICIAN PRACTICE, LLC NPI is 1861563439. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2003 S 7TH ST
HICKMAN, KY
ZIP 42050-841

The provider's authorized official is Monica Bowman .
The authorized official title is President and has the following contact phone number (615) 920-7000.

The enumeration date for this NPI number is 11/13/2006 and was last updated on 7/13/2023.

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
1163WL0100XRegistered NurseLactation ConsultantNo
2207Q00000XFamily MedicineNo
3207RC0000XInternal MedicineCardiovascular DiseaseNo
4207X00000XOrthopaedic SurgeryNo
5207YS0123XOtolaryngologyFacial Plastic SurgeryNo
62084N0400XPsychiatry & NeurologyNeurologyNo
72085R0202XRadiologyDiagnostic RadiologyNo
8208600000XSurgeryNo
92086S0129XSurgeryVascular SurgeryNo
10213ES0103XPodiatristFoot & Ankle SurgeryNo
11332B00000XDurable Medical Equipment & Medical SuppliesNo
12363A00000XPhysician AssistantNo
13363L00000XNurse PractitionerNo
14367500000XNurse Anesthetist, Certified RegisteredNo
15207R00000XInternal MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

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

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