St Lukes Regional Health Care PLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME82770 Issued in FL

Legal business name

ST LUKES REGIONAL HEALTH CARE PLC

Practice address

6030 S Florida Av, Ste 110
St Lukes Regional Health Care PLC
Lakeland, FL 33813

Phone

(863) 644-9800

Fax

(863) 644-9822

NPI assigned

Mar 8, 2007

Last updated

Jul 19, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Traci H Martin

Title

Operations Manager

Phone

(863) 644-9800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 6

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.

• Youssef B Ghaly, M.D.

  • Family Medicine Physician
  • Lakeland, FL
  • NPI 1770580334
  Medicare reassignment NPD
• Lori Ann Smith, ARNP

  • Family Nurse Practitioner
  • Plant City, FL
  • NPI 1558731158
  Medicare reassignment NPD
• Julianna Carter, PA-C

  • Family Medicine Physician
  • Lakeland, FL
  • NPI 1154166106
  NPD
• Nkechinyere Esoga

  • Family Nurse Practitioner
  • Winter Haven, FL
  • NPI 1871317230
  NPD
• Tia Nicole Flowers, PA-C

  • Physician Assistant
  • Red Oak, TX
  • NPI 1972186237

  Family Medicine

  NPD
• Katie Griggs, PA-C

  • Physician Assistant
  • Lakeland, FL
  • NPI 1376845859
  NPD (past)

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563494400000",
    "number": "1184755183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7396",
            "address_2": "ST LUKES REGIONAL HEALTH CARE PLC",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338077396",
            "telephone_number": "863-644-9800",
            "fax_number": "863-644-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6030 S FLORIDA AV, STE 110",
            "address_2": "ST LUKES REGIONAL HEALTH CARE PLC",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33813",
            "telephone_number": "863-644-9800",
            "fax_number": "863-644-9822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST LUKES REGIONAL HEALTH CARE PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2019-07-19",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "TRACI",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "863-644-9800",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME82770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsy Christina Springs, APRN
• Srinivas Samak MD.PA
• Ananta Manjula Hasini Sriram, MD
• SS Polk III Community HC LLC (Lakeland Hills Center)
• Melidza St Cyr, CRNA
• Donna M St. Rock, MA
• Ludmyla J. Staddon, ARNP
• Sally Stader, PH.D.
• Stages Health & Wellness, LLC
• Daniel Jacob Stahl, BSA

• 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 Jul 19, 2019; 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.