NPIMap

Organization Active NPI

Lakeland Regional Health Systems, Inc.

  • Multi-Specialty Clinic/Center
  • Lakeland, FL
National Provider Identifier
1497748743
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
800018020 Issued in FL
Legal business name
LAKELAND REGIONAL HEALTH SYSTEMS, INC.
Practice address
1324 Lakeland Hills Blvd
Finance Department
Lakeland, FL 33805
Phone
(863) 687-7251
Fax
(863) 687-1473
NPI assigned
Aug 23, 2005
Last updated
May 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Authorized official

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

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Multi-Specialty Clinic/Center 261QM1300X 800018020 FL Primary
Diabetes Educator Registered Nurse 163WD0400X
Anesthesiology Physician 207L00000X
Nephrology Physician 207RN0300X
Pulmonary Disease Physician 207RP1001X
Orthopaedic Surgery Physician 207X00000X
Orthopaedic Trauma Physician 207XX0801X
Psychiatry Physician 2084P0800X
Child & Adolescent Psychiatry Physician 2084P0804X
Surgical Critical Care Physician 2086S0102X
Plastic and Reconstructive Surgery Physician 2086S0122X
Trauma Surgery Physician 2086S0127X
General Practice Physician 208D00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X

Addresses

Primary practice location

1324 Lakeland Hills Blvd
Finance Department
Lakeland, FL 33805

Mailing address

1324 Lakeland Hills Blvd
Finance Department
Lakeland, FL 33805
Phone (863) 687-7251

Other identifiers 1

IdentifierTypeStateIssuer
263421000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031118000384 FL Part B Supplier - Clinic/Group Practice 8325952914 Receives reassigned benefits from 755 practitioners
Practice locations: Lakeland, FL; Plant City, FL; Venice, FL; Winter Haven, FL; Auburndale, FL; Lake Wales, FL
O20190515000302 FL MDPP Supplier - in-Person MDPP Supplier 8325952914 Practice locations: Lakeland, FL

National Provider Directory

National Provider Directory

Member organizations 18

Organizations listed as members of this organization in the National Provider Directory.

View all 18

Locations

400 Celebration Pl
Ste A
Kissimmee, FL 34747
Phone (407) 303-4238

1417 Lakeland Hills Blvd
Ste 202
Lakeland, FL 33805
Phone (863) 284-1716

1637 Shepherd Rd
Lakeland, FL 33811
Phone (863) 284-1626

2135 Harden Blvd
Lakeland, FL 33803
Phone (863) 687-1250

230 S Florida Ave
Lakeland, FL 33801

2404 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (443) 980-2011

500 S Florida Ave
Ste 210
Lakeland, FL 33801
Phone (863) 687-1222

511 W Alexander St
Ste 2
Plant City, FL 33563
Phone (813) 659-8960

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Baycare Home Care, Inc.Sarasota, FL, CCN 107710 Home health agency 5% Or Greater Indirect Ownership Interest (5.9%) Dec 1, 2021
Baycare Home Care, Inc.Dunedin, FL, CCN 107415 Home health agency 5% Or Greater Direct Ownership Interest (5.9%) Dec 1, 2021
Baycare Home Care, Inc.New Port Richey, FL, CCN 107260 Home health agency 5% Or Greater Indirect Ownership Interest (5.9%) Dec 1, 2021
Baycare Home Care, Inc.Largo, FL, CCN 107212 Home health agency 5% Or Greater Direct Ownership Interest (5.9%) Dec 1, 2021
Baycare Home Care, Inc.Tampa, FL, CCN 107285 Home health agency 5% Or Greater Direct Ownership Interest (5.9%) Dec 1, 2021
Baycare Home Care / Lakeland Regional HealthLakeland, FL, CCN 107282 Home health agency 5% Or Greater Direct Ownership Interest (5.9%) Dec 1, 2021

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 765

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 765

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684886400000",
    "number": "1497748743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLVD",
            "address_2": "FINANCE DEPARTMENT",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33805",
            "telephone_number": "863-687-7251",
            "fax_number": "863-687-1473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLVD",
            "address_2": "FINANCE DEPARTMENT",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33805",
            "telephone_number": "863-687-7251",
            "fax_number": "863-687-1473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND REGIONAL HEALTH SYSTEMS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "LANCE",
        "authorized_official_title_or_position": "SENIOR VP/CFO",
        "authorized_official_telephone_number": "863-687-1100"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "FL",
            "license": "800018020",
            "primary": true
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263421000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.