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HEALTHSTAT ON-SITE CLINIC/POLK COUNTY
NPI 1134495245
Preventive Medicine - Preventive Medicine/Occupational Environmental Medicine in Haines City, FL

Active since March 23, 2012CLIA Certified · 3 labs
631B US HIGHWAY 17 92 W, HAINES CITY, FL 33844(863) 519-3858 Get Directions Write a Review

NPPES record last updated: July 14, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Healthstat On-site Clinic/polk County NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEALTHSTAT ON-SITE CLINIC/POLK COUNTY (NPI 1134495245) is a healthcare organization registered as a preventive medicine/occupational environmental medicine in Haines City, Florida and active in the NPI registry since March 2012. The organization holds 3 active CLIA laboratory certificates and lists Jill Johnson Patton, Director Of Risk Management, as its authorized official.

NPPES Registry Identity

NPI1134495245
Entity TypeOrganization
Primary Taxonomy2083P0500X
Legal Business NameHEALTHSTAT WELLNESS-POLK HAINES
Location Address631B US HIGHWAY 17 92 WHaines City, FL 33844-5047
Mailing Address4601 Charlotte Park Dr, Suite 390Charlotte, NC 28217-1915 · (704) 529-6161 · Fax (704) 936-5570
Phone(863) 519-3858
Organization SubpartNo
Authorized OfficialJill Johnson PattonDirector Of Risk Management · (704) 936-5546
Enumeration DateMarch 23, 2012
Last NPPES UpdateJuly 14, 2020
NPPES CertifiedJuly 14, 2020
✔ NPI 1134495245 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPreventive Medicine · Preventive Medicine/Occupational Environmental MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2083P0500X
Definition
A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions.
Also ListedPharmacy · Clinic PharmacyTaxonomy 3336C0002X
631B US HIGHWAY 17 92 W, Haines City, FL 33844
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Other Names 1

Doing Business AsHealthstat On-site Clinic/polk County

Other Identifiers 1

Other5709730Ncpdp Provider Identification Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2001931

Healthstat On-Site Clinic/Santa Maria · Santa Maria, CA
Active · expires Jan 3, 2028
CLIA Number05D2001931
Laboratory TypeChronic Management
Certificate Effective DateJanuary 4, 2026
Certificate Expiration DateJanuary 3, 2028
Laboratory DirectorRaymond Lopez MD
Laboratory Phone(704) 936-5546
Laboratory LocationHealthstat On-Site Clinic/Santa Maria500W Foster Rd Employee Health Clinic, Santa Maria, CA 93455
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 42D1074056

Healthstat Inc On-Site Clinic Milliken Johnston · Johnston, SC
Active · expires Sep 20, 2027
CLIA Number42D1074056
Laboratory TypeOther
Certificate Effective DateSeptember 21, 2025
Certificate Expiration DateSeptember 20, 2027
Laboratory DirectorSally Poole
Laboratory Phone(704) 529-6161
Laboratory LocationHealthstat Inc On-Site Clinic Milliken Johnston79 Calhoun St, Johnston, SC 29832
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 21D2234608

Healthstat Wellness, Inc- Amick Farms Hurlock · Hurlock, MD
Active · expires Aug 31, 2027
CLIA Number21D2234608
Laboratory TypeChronic Disease Mgmt
Certificate Effective DateSeptember 1, 2025
Certificate Expiration DateAugust 31, 2027
Laboratory DirectorValerie Kriegisch
Laboratory Phone(704) 936-5546
Laboratory LocationHealthstat Wellness, Inc- Amick Farms Hurlock274 Nealson Street, Hurlock, MD 21643
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEALTHSTAT WELLNESS-PCSB HAINES DISPENSING
Preventive Medicine (Preventive Medicine/Occupational Environmental Medicine)
631B US HIGHWAY 17 92 W
HAINES CITY, FL 33844
Polk County (705) 661-1380

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Healthstat Wellness-Polk Haines's NPI number?

The NPI number for Healthstat Wellness-Polk Haines is 1134495245. It was assigned to this organization in the NPPES registry on March 23, 2012. The provider is doing business as Healthstat On-Site Clinic/Polk County.

Where is Healthstat Wellness-Polk Haines located?

Healthstat Wellness-Polk Haines is located at 631B Us Highway 17 92 W, Haines City, FL 33844. The listed phone number is (863) 519-3858.

What is Healthstat Wellness-Polk Haines's specialty?

The primary specialty registered for this NPI is Preventive Medicine, specializing in Preventive Medicine/Occupational Environmental Medicine, with taxonomy code 2083P0500X.

Does Healthstat Wellness-Polk Haines hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Healthstat Wellness-Polk Haines accept?

Health plans from Florida Blue HMO (a BlueCross BlueShield FL company) list Healthstat Wellness-Polk Haines as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Healthstat Wellness-Polk Haines was last updated on July 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.