NPIMap

Organization Active NPI

Lakeland Regional Health Systems, Inc

  • General Practice Physician
  • Lakeland, FL
National Provider Identifier
1114593555
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
LAKELAND REGIONAL HEALTH SYSTEMS, INC
Practice address
300 Parkview PL FL 33805
Lakeland, FL 33805-4550
Phone
(863) 687-1300
Fax
(863) 687-1305
NPI assigned
May 27, 2021
Last updated
Jan 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lance Green
Title
Evp/Cfo
Phone
(863) 687-1100

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

300 Parkview PL FL 33805
Lakeland, FL 33805-4550

Mailing address

1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543
Phone (863) 687-1100

Other identifiers 1

IdentifierTypeStateIssuer
263421018MedicaidFL

Other names 1

  • Family Health Center Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2043191Lakeland Regional Family Health Center300 Parkview PL, Lakeland, FL 33805Certificate of waiverJun 27, 2028

National Provider Directory

National Provider Directory
Tax ID family
Lakeland Regional HLTH Syst36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

Locations

300 Parkview Pl
Lakeland, FL 33805
Phone (863) 687-1300

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672790400000",
    "number": "1114593555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054543",
            "telephone_number": "863-687-1100",
            "fax_number": "863-630-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PARKVIEW PL FL 33805",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054550",
            "telephone_number": "863-687-1300",
            "fax_number": "863-687-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND REGIONAL HEALTH SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-27",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "LANCE",
        "authorized_official_title_or_position": "EVP/CFO",
        "authorized_official_telephone_number": "863-687-1100"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263421018",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.