Family Clinic at the Lake PLLC
Organization Active NPI Rural Health Clinic/Center · Savannah, TN
NPI 1295620557 · NPPES record last updated Jun 9, 2025
Key facts
- NPI
- 1295620557
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- FAMILY CLINIC AT THE LAKE PLLC
- Practice address
- 1440 Pickwick St
Savannah, TN 38372-3519 - Phone
- (731) 925-3354
- Fax
- (731) 438-3581
- NPI assigned
- Jun 9, 2025
- Organization subpart
- No
Authorized official
- Name
- Ellanikole Jackson, NP
- Title
- Owner
- Phone
- (901) 500-8629
Corporate family (same tax ID) 1
Practitioners 6
-
Ellanikole Jackson, DNP
-
Lorrie Beckham Cooksey, APRN BC FNP
-
Lauren Harbin, F.N.P
-
Dana Kay Martin, C.F.N.P.
-
Melanie A Reaves, FNP
National Provider Directory
- Tax ID family
- Family Clinic at the Lake
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes | ||
| Family Nurse Practitioner |
363LF0000X |
Addresses
Primary practice location
1440 Pickwick St
Savannah, TN 38372-3519
Mailing address
PO Box 55
Savannah, TN 38372-0055
Phone (731) 925-3354
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 44D2112604 | Other | TN | CLIA |
Other providers in Savannah, TN
- Regina Drumright
- Madalyn Durbin
- Michelle Durbin
- Mykah Ellison
- Angela Roberts Etheridge
- Family Clinic PLLC
- Family Discount Phy and Wellness Ctr
- Family Home Care Inc
- Fast Pace Medical Clinic PLLC
- Fast Pace Medical Clinic PLLC
All providers in Savannah, TN · Rural Health Clinic/Center in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.