Lakeland Allergy Asthma & Immunology

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

Legal business name

LAKELAND ALLERGY ASTHMA & IMMUNOLOGY

Practice address

4325 Highland Park Blvd
Lakeland, FL 33813-1671

Phone

(305) 318-6096

NPI assigned

Mar 6, 2019

Last updated

Apr 4, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathryn D Convers, MDNPI 1043417769

Title

Sole Member

Phone

(305) 318-6096

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19530/brand/1/csg/1/fhir/r4

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kathryn Diana Convers, M.D.

  • Allergy & Immunology Physician
  • Lakeland, FL
  • NPI 1043417769
  Medicare reassignment Care Compare group NPD Authorized official
• Robert Salzman, APRN, FNP-C

  • Nurse Practitioner
  • Lakeland, FL
  • NPI 1629686845
  Medicare reassignment Care Compare group NPD
• Charles Robert Vickers Jr., DC

  • Chiropractor
  • Lakeland, FL
  • NPI 1750392064
  NPD (past)

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554336000000",
    "number": "1861950008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 HIGHLAND PARK BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131671",
            "telephone_number": "863-213-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4325 HIGHLAND PARK BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131671",
            "telephone_number": "305-318-6096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND ALLERGY ASTHMA & IMMUNOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-06",
        "last_updated": "2019-04-04",
        "status": "A",
        "authorized_official_last_name": "CONVERS",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "305-318-6096",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Morton Senior Living LLC
• Lake Parker Facility Operations LLC (Consulate Health Care at Lake Parker)
• Lake Parker SNF Operations LLC (Charming Lakes Rehab)
• Lake Wire Pharmacy Inc
• Lakeland Alf Management, LLC (Lakeland Manor ALF)
• Lakeland Behavior Services, LLC
• Lakeland Behavioral Services Inc
• Lakeland BG Opco LLC (Oakbridge Place)
• Lakeland Birth and Gynecology LLC
• Lakeland Community Health and Rehabilitation

• Allergy & Immunology Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Allergy & Immunology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; 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.