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JACKSON PURCHASE PULMONARY MEDICINE PLLC
NPI 1992254288
Nurse Practitioner - Family in Mayfield, KY

Active since September 27, 2016CLIA 18D2013924 · Waiver
1111 MEDICAL CENTER CIR, MAYFIELD, KY 42066(270) 251-4040(855) 430-0335 Get Directions Write a Review

NPPES record last updated: September 27, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jackson Purchase Pulmonary Medicine Pllc NPPES

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

JACKSON PURCHASE PULMONARY MEDICINE PLLC (NPI 1992254288) is a healthcare organization registered as a family in Mayfield, Kentucky and active in the NPI registry since September 2016. The organization holds a CLIA Waiver certificate valid through September 27, 2026 and lists Tammy D Mccary, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1992254288
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameJACKSON PURCHASE PULMONARY MEDICINE PLLC
Location Address1111 MEDICAL CENTER CIRMayfield, KY 42066-1194
Mailing Address1111 Medical Center CirMayfield, KY 42066-1194 · (270) 251-4040 · Fax (855) 430-0335
Phone(270) 251-4040
Fax(855) 430-0335
Organization SubpartNo
Authorized OfficialTammy D MccaryOffice Manager · (270) 251-4040
Enumeration DateSeptember 27, 2016
✔ NPI 1992254288 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in KY · 3010022
1111 MEDICAL CENTER CIR, Mayfield, KY 42066
Open in Google Maps ↗

Other Identifiers 2

Medicaid7100399120KY
Medicare OSCAR/certificationK173240KY

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 2

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 of Waiver 18D2013924

Jackson Purchase Primary Care Mayfield Clinic · Mayfield, KY
Active · expires Sep 27, 2026
CLIA Number18D2013924
Laboratory TypePhysician Office
Certificate Effective DateSeptember 28, 2024
Certificate Expiration DateSeptember 27, 2026
Laboratory DirectorJonathon A. Wynstra
Laboratory Phone(270) 251-4543
Laboratory LocationJackson Purchase Primary Care Mayfield Clinic1111 Medical Center Circle, Mayfield, KY 42066
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 18D2007977

Jackson Purchase Primary Care Mayfield Clinic · Mayfield, KY
Expired · Jun 1, 2026
CLIA Number18D2007977
Laboratory TypePhysician Office
Certificate Effective DateJune 2, 2024
Certificate Expiration DateJune 1, 2026
Laboratory DirectorChristopher Dobrose
Laboratory Phone(270) 251-4055
Laboratory LocationJackson Purchase Primary Care Mayfield Clinic1111 Medical Center Circle, Mayfield, KY 42066
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

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.

JOSEPH C. SLAUGHTER MD
Internal Medicine
1111 MEDICAL CENTER CIR
MAYFIELD, KY 42066
Graves County (270) 247-8100
DR. MARK D IRVIN M.D.
Family Medicine
1111 MEDICAL CENTER CIR
MAYFIELD, KY 42066
Graves County (270) 247-8100
DURWOOD W FLOURNOY M.D.
Internal Medicine
1111 MEDICAL CENTER CIR
MAYFIELD, KY 42066
Graves County (270) 247-8100
MORGAN-HAUGH PROFESSIONAL SERVICES CORPORATION
Clinic/Center (Multi-Specialty)
1111 MEDICAL CENTER CIR
MAYFIELD, KY 42066
Graves County (270) 247-8100
ELLEN BURNETT, MD PLLC
Obstetrics & Gynecology
1111 MEDICAL CENTER CIR
MAYFIELD, KY 42066
Graves County (270) 251-4545
WYNSTRA WOMENS HEALTHCARE, PSC
Obstetrics & Gynecology
1111 MEDICAL CENTER CIR
MAYFIELD, KY 42066
Graves County (270) 251-4545
KAREN DECKARD THERACARE PHYSICAL THERAPY
Physical Therapist
1111 MEDICAL CENTER CIR
MAYFIELD, KY 42066
Graves County (270) 251-3590
ALAN L CHRISTENSEN MD PSC
Obstetrics & Gynecology
1111 MEDICAL CENTER CIR
MAYFIELD, KY 42066
Graves County (270) 251-4543

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 Jackson Purchase Pulmonary Medicine PLLC's NPI number?

The NPI number for Jackson Purchase Pulmonary Medicine PLLC is 1992254288. It was assigned to this organization in the NPPES registry on September 27, 2016.

Where is Jackson Purchase Pulmonary Medicine PLLC located?

Jackson Purchase Pulmonary Medicine PLLC is located at 1111 Medical Center Cir, Mayfield, KY 42066. The listed phone number is (270) 251-4040.

What is Jackson Purchase Pulmonary Medicine PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Jackson Purchase Pulmonary Medicine PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 18D2013924) is associated with this NPI, valid through September 27, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jackson Purchase Pulmonary Medicine PLLC was last updated on September 27, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.