Individual provider Active NPI

Jonathan Lyons Chadwick, MD

  • Otolaryngology Physician
  • Lakeland, FL
National Provider Identifier
1215019179
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
TP580 Issued in KY
Practice address
3030 Harden Blvd
Lakeland, FL 33803-7952
Phone
(863) 284-5906
NPI assigned
Oct 20, 2006
Last updated
Sep 28, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X ME133285 FL
Otolaryngology Physician 207Y00000X TP580 KY Primary

Addresses

Primary practice location

3030 Harden Blvd
Lakeland, FL 33803-7952

Mailing address

1324 Lakeland Hills Blvd
Attn: Managed Care
Lakeland, FL 33805-4543
Phone (863) 687-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220211000770 KY Practitioner - Otolaryngology 7214175074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Pennsylvania State University College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Kentucky Specialty Care LLCGroup PAC ID 1456777069, 144 clinicians

Practice addresses (Care Compare)

225 Medical Ctr Dr
Suite 303
Paducah, KY 42003-7915
Phone (270) 444-4222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.07 of 100Reported as individual
Quality
78.12
Promoting interoperability
97
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TP580KYMDObstetrics & Gynecology Physician
ME133285FLMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Mar 13, 2022 Accepting new patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Mar 13, 2022 Accepting new patients
Santa Rosa Hma Physician Management LLC PastSince Jul 4, 2021 Accepting new patients
Mercy Health Physicians Kentucky LLC Past Accepting new patients

Locations

1532 Lone Oak Rd
Ste 320
Paducah, KY 42003
Phone (270) 415-3830

225 Medical Center Dr
Ste 303
Paducah, KY 42003
Phone (270) 442-9463

Interoperability endpoints

  • Direct secure messaging: jchadwick1140812@direct.bsmhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790553600000",
    "number": "1215019179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLVD",
            "address_2": "ATTN: MANAGED CARE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054543",
            "telephone_number": "863-687-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 HARDEN BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338037952",
            "telephone_number": "863-284-5906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHADWICK",
        "first_name": "JONATHAN",
        "middle_name": "LYONS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME133285",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "KY",
            "license": "TP580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.