NPIMap

Organization Active NPI

Fairbanks Partners LLC

  • Neurological Surgery Physician
  • Celebration, FL
National Provider Identifier
1003786948
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
FAIRBANKS PARTNERS LLC
Practice address
400 Celebration PL Ste A360
Celebration, FL 34747-4970
Phone
(407) 975-0200
Fax
(407) 975-0209
NPI assigned
Nov 6, 2025
Last updated
Nov 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Authorized official

Name
Pasha Johnson
Title
Credentialing Specialist
Phone
(407) 975-0200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

400 Celebration PL Ste A360
Celebration, FL 34747-4970

Mailing address

265 E Rollins St Ste 12000
Orlando, FL 32804-5571
Phone (407) 975-0200

Other practice location 1

265 E Rollins St Ste 12000
Orlando, FL 32804-5571
Phone (407) 975-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251212000215 FL DME Supplier - Physician - General PracticeDME Supplier - Physician - Neurosurgery 8820303621 Practice locations: Celebration, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

758 N Sun Dr
Ste 112
Lake Mary, FL 32746
Phone (407) 317-5429

265 E Rollins St
Ste 12000
Orlando, FL 32804

8300 Red Bug Lake Rd
Ste 2010
Oviedo, FL 32765

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1762387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762387200000",
    "number": "1003786948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 E ROLLINS ST STE 12000",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328045571",
            "telephone_number": "407-975-0200",
            "fax_number": "407-975-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CELEBRATION PL STE A360",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474970",
            "telephone_number": "407-975-0200",
            "fax_number": "407-975-0209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "265 E Rollins St Ste 12000",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328045571",
            "country_code": "US",
            "telephone_number": "407-975-0200",
            "fax_number": "407-975-0209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAIRBANKS PARTNERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-06",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "PASHA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "407-975-0200"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Celebration, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.