Family Clinic At The Lake Pllc - Medicare Primary Care in Counce, TN

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Family Clinic At The Lake Pllc is a medicare enrolled primary clinic (Clinic/center - Rural Health) in Counce, Tennessee. The current practice location for Family Clinic At The Lake Pllc is 11268 Highway 57, Counce, Tennessee. For appointments, you can reach them via phone at (731) 689-4357. The mailing address for Family Clinic At The Lake Pllc is Po Box 140, Pickwick Dam, Tennessee and phone number is (731) 689-4357.

Family Clinic At The Lake Pllc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1578125647. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (731) 689-4357.

Contact Information

Family Clinic At The Lake Pllc
11268 Highway 57
Counce
TN 38326-3802
(731) 689-4357
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameFamily Clinic At The Lake Pllc
SpecialityClinic/Center
Location11268 Highway 57, Counce, Tennessee
Authorized Official Name and PositionEllanikole Jackson (OWNER)
Authorized Official Contact7316894357
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Family Clinic At The Lake Pllc
Po Box 140
Pickwick Dam
TN 38365-0140

Ph: (731) 689-4357		Family Clinic At The Lake Pllc
11268 Highway 57
Counce
TN 38326-3802

Ph: (731) 689-4357

NPI Details:

NPI Number1578125647
Provider Enumeration Date06/28/2019
Last Update Date10/14/2019

Medicare PECOS Information:

Medicare PECOS PAC ID7012246069
Medicare Enrollment IDO20190917001247

Medical Identifiers

Medical identifiers for Family Clinic At The Lake Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1578125647NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QR1300XClinic/center - Rural Health (* (Not Available))Primary
363L00000XNurse Practitioner (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Family Clinic At The Lake Pllc acts as a billing entity for following providers:
Provider NameEllanikole Jackson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1932676194
PECOS PAC ID: 9335484914
Enrollment ID: I20181231001911
Provider NameKrystal Lasha Long
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1528637493
PECOS PAC ID: 5496157208
Enrollment ID: I20210715001308

Reviews and Comments


Clinic/Center in Counce, TN

Joseph Peters, M.d.
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 8917 Highway 57, Counce, TN 38326
Phone: 731-689-5232    Fax: 731-689-3007

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.