Lakeland Physicians Group LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LAKELAND PHYSICIANS GROUP LLC

Practice address

517 Buena Vista St.
Lakeland, FL 33805

Phone

(863) 688-3674

Fax

(863) 616-9902

NPI assigned

Jun 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Stephen Philip Nimbargi, MDNPI 1811955362

Title

Owner

Phone

(407) 782-3702

Specialties & licenses 4

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Lakeland Physicians Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Lakeland Physicians Group

  • Internal Medicine Physician
  • Lakeland, FL
  • NPI 1225069735
  NPD tax ID

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Drhomevisitcomllc

  • Family Medicine Physician
  • Altamonte Springs, FL
  • NPI 1578830170

  Member Of

  NPD member

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen Philip Nimbargi, MD

  • Family Medicine Physician
  • Altamonte Springs, FL
  • NPI 1811955362
  Medicare reassignment Authorized official
• Viola Maf Jacob, MD

  • General Practice Physician
  • Oviedo, FL
  • NPI 1972597193

  Internal Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1174564553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150038",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327150038",
            "telephone_number": "407-782-3702",
            "fax_number": "863-648-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 BUENA VISTA ST.",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33805",
            "telephone_number": "863-688-3674",
            "fax_number": "863-616-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND PHYSICIANS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "NIMBARGI",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "PHILIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-782-3702",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME85807",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME92618",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275444400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "72117",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG9369",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "113345",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "265742201",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5324701",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lakeland Oral Surgery and Specialty Center PLLC
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• Lakeland Physicians Group
• Lakeland Primary Care Associates
• Lakeland Professional Hearing Center, Inc.
• Lakeland Regional Health
• Lakeland Regional Health Surgery Center, LLC
• Lakeland Regional Health System, Inc

• Family Medicine Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.