Pinelake Physician Practice, LLC
Pinelake Physician Practice, LLC is a healthcare organization registered as Rural Health Clinic/Center in Mayfield, KY, holding Type 2 (organization) NPI 1295960532 since 2009. The authorized official on file is Monica Bowman, Sr. Director.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1295960532 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Pinelake Physician Practice, LLC |
| Practice address | 1111 MEDICAL CENTER CIR, Mayfield, KY, 42066 |
| Phone | 2702514543 |
| Fax | 2702514544 |
| Enumeration date | 2009-05-15 |
| Last updated in NPPES | 2023-05-08 |
Authorized official
| Name | Monica Bowman |
|---|---|
| Title | Sr. Director |
| Phone | 6159207000 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207Q00000X | Family Medicine Physician | Secondary | — | — |
| 261QR1300X | Rural Health Clinic/Center | Primary | — | — |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000618910 | Other | KY | ANTHEM |
| 7100335050 | Medicaid | KY | — |
Copy-ready billing details
Provider: Pinelake Physician Practice, LLC NPI: 1295960532 Taxonomy: 261QR1300X (Rural Health Clinic/Center) Address: 1111 MEDICAL CENTER CIR, Mayfield, KY, 42066
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1538162458 | Joseph Slaughter | Individual | Internal Medicine Physician | Mayfield, KY |
| 1558364406 | Mark Irvin | Individual | Family Medicine Physician | Mayfield, KY |
| 1528061256 | Durwood Flournoy | Individual | Internal Medicine Physician | Mayfield, KY |
| 1235132960 | Jonathan Wynstra | Individual | Obstetrics & Gynecology Physician | Mayfield, KY |
| 1871564666 | Christopher Dobrose | Individual | Family Medicine Physician | Mayfield, KY |
| 1578539672 | Thomas Braxton | Individual | Sports Medicine (Family Medicine) Physician | Mayfield, KY |
| 1811959661 | Rudolph Triana | Individual | Otolaryngology/Facial Plastic Surgery Physician | Mayfield, KY |
| 1326084153 | Susanne Greene | Individual | Family Nurse Practitioner | Mayfield, KY |
Verify this record
Cross-check NPI 1295960532 against the authoritative CMS record: view Pinelake Physician Practice, LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is a Type 2 NPI?
What type of organization is Pinelake Physician Practice, LLC?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2023-05-08.