Individual provider Active NPI

Victoria Kehler Harrison, PA

  • Physician Assistant
  • Lakeland, FL
National Provider Identifier
1902118565
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9105499 Issued in FL
Practice address
1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543
Phone
(863) 380-6041
NPI assigned
Jul 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9105499 FL Primary

Addresses

Primary practice location

1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543

Mailing address

1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543
Phone (863) 687-1100

Other practice location 1

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Phone (863) 680-7000

Other practice location 2

601 1st St N
Winter Haven, FL 33881-4129
Phone (863) 294-0670

Other practice location 3

3644 Innovation Dr
Lakeland, FL 33812-4105
Phone (863) 284-1583

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vharrison16953@direct.watsonclinicad.com Watson Clinic LLP

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100928000409 FL Practitioner - Physician Assistant 8628194628 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeland Regional Health Systems IncGroup PAC ID 8325952914, 513 clinicians

Practice addresses (Care Compare)

1324 Lakeland Hill Blvd
Lakeland, FL 33805-4543
Phone (863) 687-1248

3030 Harden Blvd
Lakeland, FL 33803-7952
Phone (863) 284-5000

3525 Lakeland Hills Blvd
Lakeland, FL 33805-1965
Phone (863) 603-6565

3644 Innovation Dr
Lakeland, FL 33812-4105
Phone (863) 284-1583

Attn Managed Care
1324 Lakeland HLLS Blvd
Lakeland, FL 33805-4543

Hospital & facility affiliations

  • Lakeland Regional Medical Center Hospital, Lakeland, FL, CCN 100157

Merit-based Incentive Payment System (MIPS)

Final score
87.18 of 100Reported as apm
Quality
70.68
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9105499FLMDPhysician Assistant

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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 1

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": "1278806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1902118565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054543",
            "telephone_number": "863-687-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054543",
            "telephone_number": "863-380-6041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Lakeland Hills Blvd",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338053019",
            "country_code": "US",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 1st St N",
            "address_purpose": "LOCATION",
            "city": "Winter Haven",
            "state": "FL",
            "postal_code": "338814129",
            "country_code": "US",
            "telephone_number": "863-294-0670",
            "fax_number": "863-298-3200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3644 Innovation Dr",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338124105",
            "country_code": "US",
            "telephone_number": "863-284-1583",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "VICTORIA",
        "middle_name": "KEHLER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-11",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vharrison16953@direct.watsonclinicad.com",
            "affiliation": "Y",
            "endpointDescription": "Direct Message Address",
            "affiliationName": "Watson Clinic LLP",
            "address_1": "1430 Lakeland Hills Blvd",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338053202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.