Individual provider Active NPI

Lincoln Henry Pitcher III, ARNP

  • Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1619453305
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9313268 Issued in FL
Practice address
4740 Exploration Ave
Lakeland, FL 33812-3319
Phone
(863) 666-9020
Fax
(863) 606-0887
NPI assigned
Jul 16, 2018
Last updated
Dec 19, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9313268 FL Primary
Adult Health Nurse Practitioner 363LA2200X ARNP9313268 FL
Gerontology Nurse Practitioner 363LG0600X ARNP9313268 FL
Primary Care Nurse Practitioner 363LP2300X ARNP9313268 FL

Addresses

Primary practice location

4740 Exploration Ave
Lakeland, FL 33812-3319

Mailing address

12012 Glenhill Dr
Riverview, FL 33569-6303
Phone (813) 835-5780

Other practice location 1

12012 Glenhill Dr
Riverview, FL 33569-6303
Phone (813) 835-5780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20191227000208 FL Practitioner - Nurse Practitioner 1658705694

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9313268FLMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1619453305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12012 GLENHILL DR",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335696303",
            "telephone_number": "813-835-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 EXPLORATION AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338123319",
            "telephone_number": "863-666-9020",
            "fax_number": "863-606-0887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12012 Glenhill Dr",
            "address_purpose": "LOCATION",
            "city": "Riverview",
            "state": "FL",
            "postal_code": "335696303",
            "country_code": "US",
            "telephone_number": "813-835-5780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PITCHER",
        "first_name": "LINCOLN",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-16",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9313268",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9313268",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "ARNP9313268",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP9313268",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.