Diana Kay Fizette, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

541 S Florida Ave
Lakeland, FL 33801-5228

Phone

(863) 682-7246

Fax

(863) 682-5566

NPI assigned

Apr 29, 2019

Last updated

Feb 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Diana Kay Jarrard Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pain Medicine Inc

  • Pain Medicine Physician
  • Lakeland, FL
  • NPI 1376706283
  Medicare reassignment

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1699339317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100910",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303844548",
            "telephone_number": "863-682-7246",
            "fax_number": "863-682-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015228",
            "telephone_number": "863-682-7246",
            "fax_number": "863-682-5566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13014 Binnion Dr",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "FL",
            "postal_code": "335273661",
            "country_code": "US",
            "telephone_number": "813-267-5051",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "702 N Alexander St",
            "address_purpose": "LOCATION",
            "city": "Plant City",
            "state": "FL",
            "postal_code": "335633064",
            "country_code": "US",
            "telephone_number": "863-682-7246",
            "fax_number": "863-682-5566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIZETTE",
        "first_name": "DIANA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "JARRARD",
            "middle_name": "KAY",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.