Individual provider Active NPI

Julianna Carter, PA-C

  • Family Medicine Physician
  • Lakeland, FL
National Provider Identifier
1154166106
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
PA9118893 Issued in FL
Practice address
6030 S Florida Ave Ste 110
Lakeland, FL 33813-3351
Phone
(863) 644-9800
NPI assigned
Jul 1, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X PA9118893 FL Primary

Addresses

Primary practice location

6030 S Florida Ave Ste 110
Lakeland, FL 33813-3351

Mailing address

4412 Pawnee Path
Valrico, FL 33594-5529
Phone (904) 657-8098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260326003661 FL Practitioner - Physician Assistant 0345725495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

5617 Skytop Dr
Lithia, FL 33547-4165
Phone (813) 530-4585

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA9118893FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Regional Health Care PLC Family Medicine CurrentSince Jul 7, 2024 Accepting new patients

Locations

6030 S Florida Ave
Ste 110
Lakeland, FL 33813
Phone (863) 644-9800

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1154166106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4412 PAWNEE PATH",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335945529",
            "telephone_number": "904-657-8098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6030 S FLORIDA AVE STE 110",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338133351",
            "telephone_number": "863-644-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "JULIANNA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "PA9118893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.