JACKSON PURCHASE ENT & AESTHETIC SURGERY
NPI 1255650479
Otolaryngology - Otolaryngology/Facial Plastic Surgery in Mayfield, KY
NPI Status: Active since May 27, 2010
Contact Information
1111 MEDICAL CENTER CIR
MAYFIELD, KY
ZIP 42066
Phone: (270) 251-4080
Fax: (270) 251-4081
- Organization
- Otolaryngology
- Otolaryngology/Facial Plastic Surgery
- CLIA Number: 18D2010708
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-02-2026
About JACKSON PURCHASE ENT & AESTHETIC SURGERY
This page provides the complete NPI Profile along with additional information for Jackson Purchase Ent & Aesthetic Surgery, a provider established in Mayfield, Kentucky operating as a Otolaryngology, focusing in otolaryngology/facial plastic surgery . The healthcare provider is registered in the NPI registry with number 1255650479 assigned on May 2010. The practitioner's primary taxonomy code is 207YX0905X. The provider is registered as an organization and their NPI record was last updated 16 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Jackson Purchase Ent & Aesthetic Surgery. The authorized official of this NPI record is Timothy D Vaughn (Vice President)
- NPI
- 1255650479
- Provider Legal Name
- PINELAKE PHYSICIAN PRACTICE LLC
- Other Organization Name
- JACKSON PURCHASE ENT & AESTHETIC SURGERY
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1111 MEDICAL CENTER CIR MAYFIELD, KY 42066
- Location Phone
- (270) 251-4080
- Location Fax
- (270) 251-4081
- Mailing Address
- 1029 MEDICAL CENTER CIR MAYFIELD, KY 42066
- Mailing Phone
- (270) 251-4080
- Mailing Fax
- (270) 251-4081
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-27-2010
- Last Update Date
- 05-27-2010
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Otolaryngology Otolaryngology/Facial Plastic Surgery
- Taxonomy Code
- 207YX0905X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.
Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 18D2010708
- Facility Type
- Physician Office
- Certificate Effective Date
- August 03, 2024
- Certificate Expiration Date
- August 02, 2026
- Laboratory Director
- RUDOLPH J. TRIANA
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Jackson Purchase Ent & Aesthetic Surgery to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1255650479, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 51. The final step is to find the difference between that total and the next multiple of ten (60 - 51 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 51 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
MAYFIELD, KY 42066
MAYFIELD, KY 42066
MAYFIELD, KY 42066
MAYFIELD, KY 42066
MAYFIELD, KY 42066
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1255650479, enumerated as an "organization" on May 27, 2010.
The provider is located at 1111 MEDICAL CENTER CIR MAYFIELD, KY 42066 and the phone number is (270) 251-4080.
Otolaryngology with taxonomy code 207YX0905X and a focus in Otolaryngology/Facial Plastic Surgery.
