Individual provider Active NPI

Keiana Skinner, PA

  • Physician Assistant
  • Lakeland, FL
National Provider Identifier
1447895370
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9113823 Issued in FL
Practice address
1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065
Phone
(863) 680-7271
Fax
(866) 264-8519
NPI assigned
Nov 14, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9113823 FL Primary
Physician Assistant 363A00000X 033217 NY

Addresses

Primary practice location

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065

Mailing address

7028 Kiwano Way
Windermere, FL 34786-6797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL, MO, SC, ME, NY6 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 6

Enrollment IDStateProvider typePAC IDDetails
I20200630001604 CA Practitioner - Physician Assistant 1850713348 Reassigns benefits to 1 organization
I20210430000781 FL Practitioner - Physician Assistant 1850713348 Reassigns benefits to 3 organizations
I20240403003581 MO Practitioner - Physician Assistant 1850713348 Reassigns benefits to 1 organization
I20250402000330 SC Practitioner - Physician Assistant 1850713348 Reassigns benefits to 1 organization
I20251104000290 ME Practitioner - Physician Assistant 1850713348 Reassigns benefits to 1 organization
I20260413000722 NY Practitioner - Physician Assistant 1850713348 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Watson Clinic LLPGroup PAC ID 1456258979, 365 clinicians
Convenientmd - FFS UC LLCGroup PAC ID 5193186492, 397 clinicians

Practice addresses (Care Compare)

1033 N Pkwy Frontage Rd
Lakeland, FL 33803-0401
Phone (863) 647-8011

543 Broadway
Bangor, ME 04401-3337
Phone (207) 922-1300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
033217NYMDPhysical Therapist
PA2951MEMDPhysical Therapy Assistant
5616SCMDOccupational Therapist
PA9113823FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Convenientmd - FFS UC LLC CurrentSince Sep 30, 2025 Accepting new patients
Adventist Health Systems/Sunbelt, Inc. Physician Assistant CurrentSince Aug 1, 2021 Accepting new patients
Convenientmd - FFS UC LLC Current Accepting new patients
Musc Community Physicians CurrentSince Mar 15, 2025 Accepting new patients
Mercy Hospital Springfield CurrentSince Apr 1, 2024 Accepting new patients
Musc Community Physicians CurrentSince Mar 15, 2025 Accepting new patients
Cep America - California CurrentSince Jul 1, 2020 Accepting new patients
Mercy Hospital Springfield CurrentSince Apr 1, 2024 Accepting new patients
Adventist Health System/ Sunbelt, Inc. Physician Assistant CurrentSince Aug 1, 2021 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Sep 30, 2025 Accepting new patients
Heathrow Internal Medicine LLC Past Accepting new patients

Locations

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000

600 Center St
Auburn, ME 04210
Phone (207) 783-8951

543 Broadway
Bangor, ME 04401
Phone (207) 922-1300

18 Belmont Ave
Belfast, ME 04915
Phone (207) 607-5270

193 Bath Rd
Brunswick, ME 04011
Phone (207) 424-2272

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

Interoperability endpoints

  • Direct secure messaging: keiana.skinner.p1@direct.cmcentersinc.nextgenshare.com
  • Direct secure messaging: kskinner28679@direct.watsonclinicad.com

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1447895370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7028 KIWANO WAY",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347866797"
        },
        {
            "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": "338053065",
            "telephone_number": "863-680-7271",
            "fax_number": "866-264-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "KEIANA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113823",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "033217",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.