Organization Active NPI

LWR Family Practice Walk-in PL

  • Family Medicine Physician
  • Lakewood Ranch, FL
National Provider Identifier
1639496540
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
PA9101315 Issued in FL
Legal business name
LWR FAMILY PRACTICE WALK-IN PL
Practice address
8431 Heritage Green Way
Lakewood Ranch, FL 34212-1400
Phone
(941) 896-3900
Fax
(941) 896-3901
NPI assigned
May 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Authorized official

Name
Mary MottNPI 1114033370
Title
PA-C
Phone
(941) 896-3900

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X PA9101315 FL Primary

Addresses

Primary practice location

8431 Heritage Green Way
Lakewood Ranch, FL 34212-1400

Mailing address

8431 Heritage Green Way
Lakewood Ranch, FL 34212-1400
Phone (941) 896-3900

Other identifiers 3

IdentifierTypeStateIssuer
DR744AOtherFLPTAN
PA9101315OtherFLFLORIDA LICENSE NUMBER
DW3053OtherFLPTANRR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101029000327 FL Part B Supplier - Clinic/Group Practice 8820282288 Receives reassigned benefits from 3 practitioners
Practice locations: Bradenton, FL

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
10D2010700LWR Family Practice Walk in8431 Heritage Green Way, Bradenton, FL 34212Certificate of waiverAug 2, 2026

National Provider Directory

National Provider Directory

Locations

10910 State Road 70 E
Ste 102
Lakewood Ranch, FL 34202
Phone (941) 896-3900

8431 Heritage Green Way
Lakewood Ranch, FL 34212
Phone (941) 896-3900

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21207/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1272758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769040000000",
    "number": "1639496540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8431 HERITAGE GREEN WAY",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342121400",
            "telephone_number": "941-896-3900",
            "fax_number": "941-896-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8431 HERITAGE GREEN WAY",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342121400",
            "telephone_number": "941-896-3900",
            "fax_number": "941-896-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LWR FAMILY PRACTICE WALK-IN PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-02",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A",
        "authorized_official_last_name": "MOTT",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PA-C",
        "authorized_official_telephone_number": "941-896-3900"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "PA9101315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "DR744A",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE NUMBER",
            "identifier": "PA9101315",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTANRR",
            "identifier": "DW3053",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Ranch, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.