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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

PINELAKE PHYSICIAN PRACTICE, LLC
NPI 1295960532
Clinic/Center - Rural Health in Mayfield, KY

Active since May 15, 2009
1111 MEDICAL CENTER CIR, MAYFIELD, KY 42066(270) 251-4543(270) 251-4544 Get Directions Write a Review

NPPES record last updated: July 16, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 16, 2026, May 8, 2023, May 14, 2019 and 4 more (7 updates tracked since 2017).

About Pinelake Physician Practice, Llc NPPES

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

PINELAKE PHYSICIAN PRACTICE, LLC (NPI 1295960532) is a healthcare organization registered as a rural health in Mayfield, Kentucky and active in the NPI registry since May 2009. The organization lists Charlotte Lawrence, Secretary, as its authorized official.

NPPES Registry Identity

NPI1295960532
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NamePINELAKE PHYSICIAN PRACTICE, LLC
Location Address1111 MEDICAL CENTER CIRMayfield, KY 42066-1194
Mailing Address330 Seven Springs Way, Atten: Provider EnrollmentBrentwood, TN 37027-5098 · (615) 920-7192 · Fax (615) 920-8775
Phone(270) 251-4543
Fax(270) 251-4544
Organization SubpartNo
Authorized OfficialCharlotte LawrenceSecretary · (615) 920-7688
Enumeration DateMay 15, 2009
Last NPPES UpdateJuly 16, 20267 updates tracked since enumeration
NPPES CertifiedJuly 16, 2026
✔ NPI 1295960532 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 ListedFamily MedicineTaxonomy 207Q00000X
1111 MEDICAL CENTER CIR, Mayfield, KY 42066
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Other Identifiers 2

Other000000618910KY · Anthem
Medicaid7100335050KY

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

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

MRS. CHRISTY MARIE BAKER PHARM.D., MBA
Pharmacist
1111 MEDICAL CENTER CIR
MAYFIELD, KY 42066
Graves County (270) 247-7000
WYNSTRA WOMENS HEALTHCARE, PSC
Obstetrics & Gynecology
1111 MEDICAL CENTER CIR
MAYFIELD, KY 42066
Graves County (270) 251-4545
ALAN L CHRISTENSEN MD PSC
Obstetrics & Gynecology
1111 MEDICAL CENTER CIR
MAYFIELD, KY 42066
Graves County (270) 251-4543
MRS. JENNIFER L CARRICO APRN
Nurse Practitioner (Family)
1111 MEDICAL CENTER CIR
MAYFIELD, KY 42066
Graves County (270) 251-4040
CAITLIN ODOM PA-C
Physician Assistant
1111 MEDICAL CENTER CIR
MAYFIELD, KY 42066
Graves County (270) 251-4527
DR. JONATHAN WYNSTRA M.D.
Obstetrics & Gynecology
1111 MEDICAL CENTER CIR
MAYFIELD, KY 42066
Graves County (270) 251-4543
PINELAKE PHYSICIAN PRACTICE LLC
Otolaryngology (Otolaryngology/Facial Plastic Surgery)
1111 MEDICAL CENTER CIR
MAYFIELD, KY 42066
Graves County (270) 251-4080
MRS. SUSANNE GREENE ARNP
Nurse Practitioner (Family)
1111 MEDICAL CENTER CIR
MAYFIELD, KY 42066
Graves County (270) 251-4055

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 Pinelake Physician Practice, LLC's NPI number?

The NPI number for Pinelake Physician Practice, LLC is 1295960532. It was assigned to this organization in the NPPES registry on May 15, 2009.

Where is Pinelake Physician Practice, LLC located?

Pinelake Physician Practice, LLC is located at 1111 Medical Center Cir, Mayfield, KY 42066. The listed phone number is (270) 251-4543.

What is Pinelake Physician Practice, LLC'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 Pinelake Physician Practice, LLC was last updated on July 16, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.