Polk Concierge Medical Group, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

POLK CONCIERGE MEDICAL GROUP, LLC

Practice address

304 E Pine St # 1143
Lakeland, FL 33801-4969

Phone

(863) 339-2025

NPI assigned

Apr 11, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Asia M Standifer, APRNNPI 1841872462

Title

Ceo

Phone

(352) 807-2197

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Asia Standifer

  • Acute Care Nurse Practitioner
  • Tampa, FL
  • NPI 1841872462
  NPD Authorized official

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1235824640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 E PINE ST # 1143",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338014969",
            "telephone_number": "863-339-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 E PINE ST # 1143",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338014969",
            "telephone_number": "863-339-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLK CONCIERGE MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "STANDIFER",
        "authorized_official_first_name": "ASIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "352-807-2197",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Anne Pogue, OTR/L
• Kenley Pointer, PA
• Polaris Medical Group PA
• Madhurya Polavarapu, MD
• Melissa Polisar, CRNA
• Polk County Board of County Commissioners
• Polk Emergency Group LLC
• Polk Wellcare Corp
• Jessica Polk
• Antionette Pollard

• Nurse Practitioner in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.