NPIMap

Organization Active NPI

Lakeland Medical Associates

  • Family Medicine Physician
  • Athens, TX
National Provider Identifier
1528063534
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J4022 Issued in TX
Legal business name
LAKELAND MEDICAL ASSOCIATES
Practice address
117 Medical Cir
Athens, TX 75751-9003
Phone
(903) 676-3200
Fax
(833) 428-4545
NPI assigned
Jun 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Authorized official

Name
Michael SwartwoodNPI 1487883153
Title
Authorized Official
Phone
(903) 676-3200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X J4022 TX Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X L1095 TX
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X H6314 TX

Addresses

Primary practice location

117 Medical Cir
Athens, TX 75751-9003

Mailing address

117 Medical Cir
Athens, TX 75751-9003
Phone (903) 676-3200

Other practice location 1

170 Municipal Dr
Gun Barrel City, TX 75156-3704
Phone (903) 887-7992

Other identifiers 3

IdentifierTypeStateIssuer
00D969OtherTXBCBS GROUP NUMBER
111549503MedicaidTX
111549502MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060202000852 TX Part B Supplier - Clinic/Group Practice 2567476146 Receives reassigned benefits from 16 practitioners
Practice locations: Athens, TX; Gun Barrel City, TX

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
45D0483535Lakeland Medical Associates117 Medical Circle, Athens, TX 75751ComplianceJun 21, 2028
45D1004799Lakeland Medical Associates170 Municipal Drive, Gun Barrel City, TX 75156ComplianceMar 29, 2027

National Provider Directory

National Provider Directory

Locations

117 Medical Cir
Athens, TX 75751
Phone (903) 676-3200

170 Municipal Dr
Gun Barrel City, TX 75156
Phone (903) 887-7992

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777334400000",
    "number": "1528063534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 MEDICAL CIR",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757519003",
            "telephone_number": "903-676-3200",
            "fax_number": "833-428-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 MEDICAL CIR",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757519003",
            "telephone_number": "903-676-3200",
            "fax_number": "833-428-4545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 Municipal Dr",
            "address_purpose": "LOCATION",
            "city": "Gun Barrel City",
            "state": "TX",
            "postal_code": "751563704",
            "country_code": "US",
            "telephone_number": "903-887-7992",
            "fax_number": "833-428-4546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKELAND MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A",
        "authorized_official_last_name": "SWARTWOOD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "903-676-3200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J4022",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "L1095",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "H6314",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "00D969",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111549503",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111549502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.