NPIMap

Individual provider Active NPI

Lawrence Lindsay Pedley Jr., PA-C

  • Physician Assistant
  • Daytona Beach, FL
National Provider Identifier
1801239223
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9107218 Issued in FL
Practice address
350 N Clyde Morris Blvd
Daytona Beach, FL 32114-2733
Phone
(386) 238-3221
Fax
(386) 238-3235
NPI assigned
Apr 16, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10001500A IN
Physician Assistant 363A00000X PA1821 KY
Physician Assistant 363A00000X PA9107218 FL Primary

Addresses

Primary practice location

350 N Clyde Morris Blvd
Daytona Beach, FL 32114-2733

Mailing address

350 N Clyde Morris Blvd
Daytona Beach, FL 32114-2733
Phone (386) 238-3221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151002000513 FL Practitioner - Physician Assistant 3173752813 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians

Practice addresses (Care Compare)

120 Cypress Edge Dr
Suite 202
Palm Coast, FL 32164-8454
Phone (386) 586-4280

1200 Lexington Green LN
Sanford, FL 32771-1013

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

Hospital & facility affiliations

  • AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118
  • Adventhealth Palm Coast Parkway Hospital, Palm Coast, FL, CCN 100363
  • Adventhealth Daytona Beach Hospital, Daytona Beach, FL, CCN 100068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10001500AINMDPhysician Assistant

Practice roles (4 of 6)

OrganizationSpecialtyStatusNew patients
Adventist Health System /Sunbelt, Inc. Physician Assistant CurrentSince Sep 11, 2018 Accepting new patients
Adventist Health System/ Sunbelt, Inc. Physician Assistant CurrentSince Sep 11, 2018 Accepting new patients
Halifax Healthcare Systems Inc CurrentSince Apr 17, 2017 Accepting new patients
Poseidon Inpatient Services, LLC Past Accepting new patients

Locations

440 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 788-2000

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

4660 13th St
Saint Cloud, FL 34769
Phone (321) 805-4650

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: lpedley71476@adventhealth.direct-ci.com

Organizations & group practices 9

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1801239223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142733",
            "telephone_number": "386-238-3221",
            "fax_number": "386-238-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142733",
            "telephone_number": "386-238-3221",
            "fax_number": "386-238-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDLEY",
        "first_name": "LAWRENCE",
        "middle_name": "LINDSAY",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-16",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001500A",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1821",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.