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KENTUCKY LAKE UROLOGY CLINIC
NPI 1528025574
Urology in Paris, TN

Active since April 26, 2006CLIA 44D0315313 · Microscopy
1002 CORNERSTONE DR, STE A, PARIS, TN 38242(731) 642-8884(731) 642-8865 Get Directions Write a Review

NPPES record last updated: January 22, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kentucky Lake Urology Clinic NPPES

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

KENTUCKY LAKE UROLOGY CLINIC (NPI 1528025574) is a healthcare organization registered as an urology in Paris, Tennessee and active in the NPI registry since April 2006. The organization holds a CLIA Microscopy certificate valid through May 5, 2028 and lists Leigh M Horton, Asst Office Manager, as its authorized official.

NPPES Registry Identity

NPI1528025574
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameKENTUCKY LAKE UROLOGY CLINIC
Location Address1002 CORNERSTONE DR, STE AParis, TN 38242
Mailing Address1002 Cornerstone Dr, Ste AParis, TN 38242 · (731) 642-8884 · Fax (731) 642-8865
Phone(731) 642-8884
Fax(731) 642-8865
Organization SubpartNo
Authorized OfficialLeigh M HortonAsst Office Manager · (731) 642-8884
Enumeration DateApril 26, 2006
Last NPPES UpdateJanuary 22, 2013
✔ NPI 1528025574 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.
1002 CORNERSTONE DR, Paris, TN 38242
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Other Identifiers 3

OtherCM3751TN · Railroad Medicare
Medicare ID-Type Unspecified3701995TN
Medicaid3701995TN

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 44D0315313

West Tennessee Medical Group Dba Kentucky Lake Urology Paris · Paris, TN
Active · expires May 5, 2028
CLIA Number44D0315313
Laboratory TypePhysician Office
Certificate Effective DateMay 6, 2026
Certificate Expiration DateMay 5, 2028
Laboratory DirectorDr. Joe Mobley III
Laboratory Phone(731) 642-8884
Laboratory LocationWest Tennessee Medical Group Dba Kentucky Lake Urology Paris1002 Cornerstone Dr Suite A, Paris, TN 38242
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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.

KENTUCKY LAKE SURGERY CENTER LLC
Clinic/Center (Ambulatory Surgical)
1002 CORNERSTONE DR, SUITE B
PARIS, TN 38242
Henry County (731) 644-2150
TAMARA M ROBERTSON FNP
Nurse Practitioner
1002 CORNERSTONE DR, SUITE A
PARIS, TN 38242
Henry County (731) 642-8884
JOE DICK MOBLEY JR. MD
Urology
1002 CORNERSTONE DR, STE A
PARIS, TN 38242
Henry County (731) 642-8884

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 Kentucky Lake Urology Clinic's NPI number?

The NPI number for Kentucky Lake Urology Clinic is 1528025574. It was assigned to this organization in the NPPES registry on April 26, 2006.

Where is Kentucky Lake Urology Clinic located?

Kentucky Lake Urology Clinic is located at 1002 Cornerstone Dr Ste A, Paris, TN 38242. The listed phone number is (731) 642-8884.

What is Kentucky Lake Urology Clinic's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Does Kentucky Lake Urology Clinic hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 44D0315313) is associated with this NPI, valid through May 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kentucky Lake Urology Clinic was last updated on January 22, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years 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.