Individual provider Active NPI

Jaison Joseph Luke, ARNP

  • Family Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1184074759
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP 9350331 Issued in FL
Practice address
1705 Lakeland Hills Blvd Ste 1
Lakeland, FL 33805-3061
Phone
(863) 688-6051
Fax
(208) 977-3177
NPI assigned
Jun 15, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP 9350331 FL Primary

Addresses

Primary practice location

1705 Lakeland Hills Blvd Ste 1
Lakeland, FL 33805-3061

Mailing address

1705 Lakeland Hills Blvd Ste 1
Lakeland, FL 33805-3061
Phone (863) 688-6051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161004000334 FL Practitioner - Nurse Practitioner 6204124407 Reassigns benefits to 3 organizations
I20221207001309 NY Practitioner - Nurse Practitioner 6204124407 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
339240NYMDInternal Medicine Physician
ARNP 9350331FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Episource LLC CurrentSince Mar 1, 2020 Accepting new patients
Health First Primary Care, L.L.C CurrentSince Aug 1, 2021 Accepting new patients
Art of Dermatology PLLC CurrentSince Dec 1, 2025 Accepting new patients
Alan Bolton, MD, PC PastSince Mar 1, 1999 Accepting new patients

Locations

500 W 190th St
Fl 4
Gardena, CA 90248
Phone (424) 292-2923

14290 Metropolis Ave
Ste 2
Fort Myers, FL 33912
Phone (239) 356-3503

8000 SW 117th Ave
Ste 205
Miami, FL 33183
Phone (305) 273-9100

2350 Vanderbilt Beach Rd
Ste 301
Naples, FL 34109
Phone (239) 356-3503

10850 Temple Ter
Ste 300
Seminole, FL 33772
Phone (727) 398-5295

12332 Race Track Rd
Tampa, FL 33626
Phone (813) 756-4383

208 W Dr Martin Luther King Jr Blvd
Tampa, FL 33603
Phone (813) 223-3300

28903 Woodward Ave
Berkley, MI 48072
Phone (248) 542-7141

329 S Oyster Bay Rd
Plainview, NY 11803
Phone (714) 452-1961

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1184074759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 LAKELAND HILLS BLVD STE 1",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053061",
            "telephone_number": "863-688-6051",
            "fax_number": "208-977-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 LAKELAND HILLS BLVD STE 1",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053061",
            "telephone_number": "863-688-6051",
            "fax_number": "208-977-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH LUKE",
        "first_name": "JAISON",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-15",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP 9350331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.