Individual provider Active NPI

Jacqueline Lindsey, MD

  • Family Medicine Physician
  • Lake Wales, FL
National Provider Identifier
1861461949
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME50786 Issued in FL
Practice address
410 S 11TH St
Lake Wales, FL 33853
Phone
(863) 676-1433
NPI assigned
Mar 14, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME50786 FL
Family Medicine Physician 207Q00000X ME50786 FL Primary

Addresses

Primary practice location

410 S 11TH St
Lake Wales, FL 33853

Mailing address

8390 Champions Gate Blvd
Ste 306
Champions Gate, FL 33896
Phone (407) 390-1677

Other identifiers 1

IdentifierTypeStateIssuer
05610COtherFLBCBS

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100310000242 FL Practitioner - Family PracticePractitioner - Emergency Medicine 9931000171 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME50786FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Ridgewood Emergency Group, LLC Emergency Medicine CurrentSince Nov 1, 2018 Accepting new patients
Ridgewood Emergency Group, LLC Emergency Medicine CurrentSince Nov 1, 2018 Accepting new patients
Advance Technological Radiology, PA Past Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

40100 Highway 27
Davenport, FL 33837
Phone (863) 419-2496

700 W Oak St
Kissimmee, FL 34741
Phone (407) 518-3553

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

8300 Red Bug Lake Rd
Oviedo, FL 32765
Phone (407) 359-6007

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

1401 W Seminole Blvd
Sanford, FL 32771
Phone (317) 805-2316

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1861461949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8390 CHAMPIONS GATE BLVD",
            "address_2": "STE 306",
            "city": "CHAMPIONS GATE",
            "state": "FL",
            "postal_code": "33896",
            "telephone_number": "407-390-1677",
            "fax_number": "407-390-1765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 S 11TH ST",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "33853",
            "telephone_number": "863-676-1433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSEY",
        "first_name": "JACQUELINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME50786",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME50786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "05610C",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

Verify at the official NPI Registry.