Individual provider Active NPI

Charde Holt, PA

  • Physician Assistant
  • Lakeland, FL
National Provider Identifier
1164075149
Registry record updated Oct 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065
Phone
(863) 680-7000
Fax
(866) 264-8519
NPI assigned
Jul 19, 2019
Last updated
Oct 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065

Mailing address

433 Las Colinas Blvd E Ste 350
Irving, TX 75039-5529
Phone (863) 680-7000

Other names 1

  • Charde Blocker Former name

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
I20191023000056 FL Practitioner - Physician Assistant 8123350246 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Pain Relief Group PLLCGroup PAC ID 4688960271, 80 clinicians

Practice addresses (Care Compare)

2114 Seven Springs Blvd
Suite 100
New Port Richey, FL 34655-3908
Phone (727) 597-8430

3450 E Fletcher Ave
Suite 350
Tampa, FL 33613-4699
Phone (813) 739-7493

7518 Cypress Gardens Blvd
Winter Haven, FL 33884-3200
Phone (863) 508-1340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Watson Clinic LLP PastSince Sep 16, 1993 Accepting new patients
Watson Clinic LLP Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cholt28669@direct.watsonclinicad.com

Organizations & group practices 11

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

NPI Registry JSON

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793318400000",
    "number": "1164075149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 LAS COLINAS BLVD E STE 350",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750395529",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053065",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLT",
        "first_name": "CHARDE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-19",
        "last_updated": "2026-10-30",
        "certification_date": "2026-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARDE",
            "last_name": "BLOCKER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.