NPIMap

Organization Active NPI

Watson Clinic LLP

  • Internal Medicine Physician
  • Lakeland, FL
National Provider Identifier
1316940695
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WATSON CLINIC LLP
Practice address
1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Phone
(863) 680-7000
Fax
(866) 264-8519
NPI assigned
May 31, 2005
Last updated
Mar 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Authorized official

Name
Jason Hirsbrunner
Title
Chief Executive Officer
Phone
(863) 680-7007

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X NU
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary
Cardiovascular Disease Physician 207RC0000X NU
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU
Gastroenterology Physician 207RG0100X NU
Interventional Cardiology Physician 207RI0011X NU
Infectious Disease Physician 207RI0200X NU
Nephrology Physician 207RN0300X NU
Pulmonary Disease Physician 207RP1001X NU
Rheumatology Physician 207RR0500X NU
Obstetrics & Gynecology Physician 207V00000X NU
Ophthalmology Physician 207W00000X NU
Orthopaedic Surgery Physician 207X00000X NU
Multi-Specialty Clinic/Center 261QM1300X NU

Addresses

Primary practice location

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019

Mailing address

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Phone (863) 680-7000

Other identifiers 2

IdentifierTypeStateIssuer
053990200MedicaidFL
200568900OtherFLPC-ACE PROGRAM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CO3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031215000113 FL Part B Supplier - Clinic/Group Practice 1456258979 Receives reassigned benefits from 410 practitioners
O20100930030626 FL DME Supplier - Multi-Specialty - Physician 1456258979 Practice locations: Lakeland, FL
O20241113002087 CO Part B Supplier - Clinic/Group Practice 1456258979 Receives reassigned benefits from 1 practitioner
Practice locations: Ridgway, CO

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Saint Luke's Rehabilitation Therapy2 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.

Locations (25 of 29)

2000 Osprey Blvd
Bartow, FL 33830

2000 Osprey Blvd
Ste 100
Bartow, FL 33830
Phone (863) 519-7005

2000 Osprey Blvd
Ste 201
Bartow, FL 33830
Phone (863) 534-2728

602 Vonderburg Dr
#100
Brandon, FL 33511

602 Vonderburg Dr
Ste 101
Brandon, FL 33511
Phone (813) 530-4944

1348 Highway 60 E
Lake Wales, FL 33853
Phone (863) 676-9510

1550 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 680-7560

1755 N Florida Ave
Lakeland, FL 33805
Phone (863) 904-6200

2020 Edgewood Dr S
Lakeland, FL 33803
Phone (813) 665-6211

2105 Harden Blvd
Lakeland, FL 33803
Phone (863) 284-0534

2176 E County Road 540A
Lakeland, FL 33813
Phone (863) 393-9472

2180 E County Road 540A
Lakeland, FL 33813
Phone (863) 680-7267

2300 E County Road 540A
Lakeland, FL 33813
Phone (863) 607-3333

3187 US Highway 98 N
Lakeland, FL 33805
Phone (863) 603-2130

3615 S Florida Ave
Lakeland, FL 33803
Phone (863) 904-6222

3615 S Florida Ave
Ste 710
Lakeland, FL 33803
Phone (863) 904-6222

402 S Kentucky Ave
Fl 5
Lakeland, FL 33801

4060 Lakeland Highlands Rd
Lakeland, FL 33812

909 S Lakeside Ave
Lakeland, FL 33803
Phone (352) 255-5023

687 S Bluford Ave
Ocoee, FL 34761
Phone (407) 347-3032

8100 Chancellor Dr
Ste 130
Orlando, FL 32809
Phone (407) 857-7000

1211 W Reynolds St
Plant City, FL 33563
Phone (813) 752-2136

924 Cypress Village Blvd
Ruskin, FL 33573
Phone (813) 633-6121

924 Cypress Village Blvd
Ste A
Ruskin, FL 33573
Phone (813) 633-6121

12902 Usf Magnolia Dr
Tampa, FL 33612
Phone (813) 745-2720

Practitioners & affiliated clinicians

Practitioners 446

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.

View all 446

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709251200000",
    "number": "1316940695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053019",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053019",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATSON CLINIC LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A",
        "authorized_official_last_name": "HIRSBRUNNER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "863-680-7007"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "053990200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PC-ACE PROGRAM",
            "identifier": "200568900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.