NPIMap

Organization Active NPI

Lakeland Regional Health Systems, Inc

  • Multi-Specialty Clinic/Center
  • Plant City, FL
National Provider Identifier
1497321822
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
LAKELAND REGIONAL HEALTH SYSTEMS, INC
Practice address
511 W Alexander St
Plant City, FL 33563-7116
Phone
(863) 284-5000
Fax
(863) 413-4744
NPI assigned
May 27, 2021
Last updated
Jan 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Authorized official

Name
Lance Green
Title
Evp/Cfo
Phone
(863) 687-1100

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X
Rheumatology Physician 207RR0500X
Pediatrics Physician 208000000X
General Practice Physician 208D00000X

Addresses

Primary practice location

511 W Alexander St
Plant City, FL 33563-7116

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
263421017MedicaidFL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2230229Lakeland Regional Health511 W Alexander Street, Plant City, FL 33563Certificate of waiverJul 20, 2027

National Provider Directory

National Provider Directory
Tax ID family
Lakeland Regional HLTH Syst36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

Organizations that report the same tax identification number in the National Provider Directory.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672790400000",
    "number": "1497321822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLVD",
            "address_2": "MANAGED CARE DEPT",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33805",
            "telephone_number": "863-687-1100",
            "fax_number": "863-630-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 W ALEXANDER ST",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335637116",
            "telephone_number": "863-284-5000",
            "fax_number": "863-413-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND REGIONAL HEALTH SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-27",
        "last_updated": "2023-01-04",
        "certification_date": "2022-12-22",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "LANCE",
        "authorized_official_title_or_position": "EVP/CFO",
        "authorized_official_telephone_number": "863-687-1100"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263421017",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plant City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.