HEALTHSTAT WELLNESS POLK-LAKELAND (NPI# 1093187429) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093187429 |
| Entity Type | Organization |
| Organization Name | HEALTHSTAT WELLNESS POLK-LAKELAND |
| Practice Address |
3215 Winter Lake Road Lakeland FL 33803 |
| Mailing Address |
4651 Charlotte Park Dr Suite 300 Charlotte NC 28217-1956 |
| Practice Telephone | 7045296161 |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2020-07-14 |
| Authorized Official Name | JILL JOHNSON PATTON (DIRECTOR OF RISK MANAGEMENT) |
| Authorized Official Telephone | 7049365546 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0500X |
Preventive Medicine Specialization: Preventive Medicine/Occupational Environmental Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
3215 WINTER LAKE ROAD |
| City | LAKELAND |
| State | FL |
| Zip Code | 33803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801250204 | Samantha Knight | Dietitian, Registered | 3215 Winter Lake Road, Lakeland, FL 33803 | 2016-04-12 |
| 1003270570 | Deborah Reyes | Dietitian, Registered | 3215 Winter Lake Road, Lakeland, FL 33803 | 2016-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861964819 | Steven P Agelidis | Counselor | 2020 S. Florida Ave, Suite 207, Lakeland, FL 33803 | 2018-12-31 |
| 1902316201 | Kesara Mai Ngam | Massage Therapist | 117 West Oak Drive, Lakeland, FL 33803 | 2017-10-02 |
| 1396260618 | Suncoast Behavioral Solutions, LLC | Behavioral Analyst | 1920 E Edgewood Dr Apt A8, Lakeland, FL 33803 | 2017-08-08 |
| 1316484413 | Daniel Jacob Stahl | Behavior Technician | 145 East Edgewood Drive, Lakeland, FL 33803 | 2017-01-26 |
| 1780037002 | Shelley Stettinius | Behavioral Analyst | 145 East Edgewood Dr, Lakeland, FL 33803 | 2016-07-21 |
| 1396106654 | Highlands Occupational Therapy, Inc | Occupational Therapist | 2000 East Edgewood Drive, Suite 114, Lakeland, FL 33803 | 2016-03-15 |
| 1003289570 | Jayna Dinsmore | Physical Therapy Assistant | 321 Imperial Blvd, D38, Lakeland, FL 33803 | 2015-11-05 |
| 1962812545 | Florida Presbyterian Homes, Inc | Nursing Facility/Intermediate Care Facility | 901 Lakeside Avenue, Lakeland, FL 33803 | 2014-05-05 |
| 1710316336 | Trinity Endodontics | Health Maintenance Organization | 1602 S. Florida Ave, Ste #1, Lakeland, FL 33803 | 2013-11-04 |
| 1578800082 | Margaret S Henry | Massage Therapist | 213 Kerney Wood St., Lakeland, FL 33803 | 2013-01-04 |
| Find all providers in zip 33803 | ||||
| Taxonomy Code | 2083P0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Preventive Medicine/Occupational Environmental Medicine |
| A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548511561 | Healthstat Wellness City of Lakeland | Preventive Medicine | 491 N Lake Parker Ave, Lakeland, FL 33801 | 2012-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922606631 | Healthstat Wellness Health Center John Knox Village | Preventive Medicine | 500 South West 3rd Street, Suite 100, Pompano Beach, FL 33060 | 2020-10-14 |
| 1215588306 | Jmc Tallahassee, LLC | Preventive Medicine | 1838 Jacliff Court, Tallahassee, FL 32308 | 2019-09-20 |
| 1912463746 | Healthstat Wellness Pasco Land O Lakes | Preventive Medicine | 4111 Land O Lakes Blvd Ste 301, Land O Lakes, FL 34639-4403 | 2019-02-18 |
| 1811436884 | Healthstat Onsite Clinic Mosaic Highland Oaks | Preventive Medicine | 10210 Highland Manor Dr Ste 350, Tampa, FL 33610-9177 | 2017-02-23 |
| 1467902353 | Healthstat Onsite Clinic Mosaic South Pierce | Preventive Medicine | 7450 Hwy 630, Mulberry, FL 33860 | 2016-10-04 |
| 1427418003 | Healthstat Onsite Clinic Duette | Preventive Medicine | 1295 Duette Rd, Duette, FL 34219-7921 | 2016-02-25 |
| 1588054514 | Healthstat Onsite Clinic Mosaic Plant City | Preventive Medicine | 10608 Paul Buchman Hwy, Plant City, FL 33565 | 2015-01-29 |
| 1356740757 | Healthstat Onsite Clinic- Mosaic Mulberry | Preventive Medicine | 3095 Highway 640 West, Mulberry, FL 33860 | 2014-08-21 |
| 1538568936 | Healthstat Onsite Clinic- Mosaic Bradley | Preventive Medicine | 11200 State Rd. 37 South, Bradley, FL 33835 | 2014-08-21 |
| 1538568019 | Healthstat Onsite Clinic- Mosaic Ft. Meade | Preventive Medicine | 5880 Manley Rd, Fort Meade, FL 33841-9257 | 2014-08-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.