Individual provider Active NPI

Fallon Charlinda Boston, APRN

  • Gastroenterology Registered Nurse
  • Lakeland, FL
National Provider Identifier
1912817677
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology Registered NurseTaxonomy code 163WG0100X
License
11049308 Issued in FL
Practice address
4120 US Highway 98 N
Lakeland, FL 33809-3854
Phone
(813) 284-6860
NPI assigned
Sep 8, 2026
Last updated
Sep 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Registered Nurse 163WG0100X 11049308 FL Primary

Addresses

Primary practice location

4120 US Highway 98 N
Lakeland, FL 33809-3854

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1788825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1912817677",
    "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": "4120 US HIGHWAY 98 N",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338093854",
            "telephone_number": "813-284-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTON",
        "first_name": "FALLON",
        "middle_name": "CHARLINDA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-08",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gastroenterology",
            "state": "FL",
            "license": "11049308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.