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FAMILY CLINIC AT THE LAKE PLLC
NPI 1295620557
Clinic/Center - Rural Health in Savannah, TN

Active since June 09, 2025
1440 PICKWICK ST, SAVANNAH, TN 38372(731) 925-3354(731) 438-3581 Get Directions Write a Review

NPPES record last updated: June 9, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Family Clinic At The Lake Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAMILY CLINIC AT THE LAKE PLLC (NPI 1295620557) is a healthcare organization registered as a rural health in Savannah, Tennessee and active in the NPI registry since June 2025. The organization lists Ellanikole Jackson, Owner, as its authorized official.

NPPES Registry Identity

NPI1295620557
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameFAMILY CLINIC AT THE LAKE PLLC
Location Address1440 PICKWICK STSavannah, TN 38372-3519
Mailing AddressPo Box 55Savannah, TN 38372-0055 · (731) 925-3354 · Fax (731) 438-3581
Phone(731) 925-3354
Fax(731) 438-3581
Organization SubpartNo
Authorized OfficialEllanikole JacksonOwner · (901) 500-8629
Enumeration DateJune 9, 2025
NPPES CertifiedJune 9, 2025
✔ NPI 1295620557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
1440 PICKWICK ST, Savannah, TN 38372
Open in Google Maps ↗

Other Identifiers 1

Other44D2112604TN · Clia

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ASHLEY WALLACE FNP
Nurse Practitioner (Family)
1440 PICKWICK ST
SAVANNAH, TN 38372
Hardin County (731) 925-3354
FAMILY CLINIC PLLC
Nurse Practitioner
1440 PICKWICK ST
SAVANNAH, TN 38372
Hardin County (731) 438-3456
MELANIE A REAVES PLLC
Clinic/Center (Rural Health)
1440 PICKWICK ST
SAVANNAH, TN 38372
Hardin County (731) 925-3354

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Family Clinic At The Lake PLLC's NPI number?

The NPI number for Family Clinic At The Lake PLLC is 1295620557. It was assigned to this organization in the NPPES registry on June 9, 2025.

Where is Family Clinic At The Lake PLLC located?

Family Clinic At The Lake PLLC is located at 1440 Pickwick St, Savannah, TN 38372. The listed phone number is (731) 925-3354.

What is Family Clinic At The Lake PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

When was this NPI record last updated?

The NPPES record for Family Clinic At The Lake PLLC was last updated on June 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.