LAKESIDE PRIMARY CARE, PSC – Rural Health Clinic/Center, NPI 1043790983

LAKESIDE PRIMARY CARE, PSC is a healthcare provider. based in Burnside, Kentucky. specializing in Rural Health Clinic/Center. The NPI Number for LAKESIDE PRIMARY CARE, PSC is 1043790983

Main info

Organization
Name
LAKESIDE PRIMARY CARE, PSC
NPI
1043790983
Phone
(606) 310-2640
Address
PO BOX 85
Authorized Official
MRS. THURESA S CASH APRN/OWNER APRN
Enumeration Date
20 August 2018
Last Update Date
23 April 2026
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness85
Years active:7State licenses:0Digital endpointsOther names

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Provider Addresses for LAKESIDE PRIMARY CARE, PSC

  • 85, Grahams Road, Burnside, Christchurch, Fendalton-Waimari-Harewood Community, Christchurch City, Canterbury, 8041, New Zealand

    BURNSIDE, KY 42519

    Phone: (606) 310-2640

    Type: Mailing

  • Highway, Martock, Ash, South Somerset, Somerset, South West England, England, TA12 6NT, United Kingdom

    SOMERSET, KY 42501

    Phone: (606) 341-1339

    Fax: (606) 341-1340

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-11-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-11-30 (924 days ago).

Enrollment records

2

Earliest due date

2023-11-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20181029000692ORural Health ClinicKY2024-08-31
O20181120001820OClinic/Group PracticeKY2023-11-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 42519)

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Reviews

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Frequently asked questions

What is LAKESIDE PRIMARY CARE, PSC's NPI number?
LAKESIDE PRIMARY CARE, PSC's NPI is 1043790983 — the number used across U.S. healthcare to identify this provider.
Is there an active status for LAKESIDE PRIMARY CARE, PSC?
For scheduling context, LAKESIDE PRIMARY CARE, PSC is shown as active in the registry.
How would a patient describe LAKESIDE PRIMARY CARE, PSC's focus?
For LAKESIDE PRIMARY CARE, PSC, the primary taxonomy reads as Rural Health Clinic/Center. Clinical services aligned with this taxonomy classification.
Where in Kentucky is LAKESIDE PRIMARY CARE, PSC registered?
Use Burnside, Kentucky as the headline location for LAKESIDE PRIMARY CARE, PSC here.
When was this NPI issued?
Enumeration for LAKESIDE PRIMARY CARE, PSC is noted as August 20, 2018 where the registry provides it.

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