NPIMap

Organization Active NPI

Adventist Health System-Sunbelt Inc

Doing business as Adventhealth Family Medicine Frostproof

  • Rural Health Clinic/Center
  • Frostproof, FL
National Provider Identifier
1013434067
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ADVENTIST HEALTH SYSTEM-SUNBELT INC
Doing business as
Adventhealth Family Medicine Frostproof
Frostproof Family Health
Practice address
200 S Scenic Hwy
Frostproof, FL 33843-2125
Phone
(863) 546-6384
NPI assigned
Aug 29, 2017
Last updated
Apr 21, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVENTIST HEALTH SYSTEM-SUNBELT INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Authorized official

Name
Jason Dunkel
Title
Ceo
Phone
(727) 942-5002

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary
Medical Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363AM0700X

Addresses

Primary practice location

200 S Scenic Hwy
Frostproof, FL 33843-2125

Mailing address

4101 Sun N Lake Blvd
Sebring, FL 33872-2131
Phone (863) 314-4466

Other names 2

  • ADVENTHEALTH FAMILY MEDICINE FROSTPROOF Doing business as
  • Frostproof Family Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171117000110 FL Part A Provider - Rural Health Clinic 0749232445 Practice locations: Frostproof, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013434067. Details of each certification follow.

Rural health clinic certification: CCN 103975

Legal name
ADVENTIST HEALTH SYSTEM-SUNBELT INC
Doing business as
ADVENTHEALTH FAMILY MEDICINE FROSTPROOF
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 27, 2018
Last certification
Dec 27, 2018
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
May 2, 1973 in FL
Enrollment address
200 S Scenic Hwy
Frostproof, FL 33843-2125
Related CCNs
101300

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Walker Memorial Medical18 organizations share this tax ID, including this one
Part of
Walker Memorial Medical

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Ownership & related parties

All disclosed owners & managing parties 19

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jason Dunkel Individual Contracted Managing Employee Jul 31, 2022
Corporate OfficerBoard Secretary Dec 8, 2022
Corporate DirectorDirector Aug 25, 2022
Operational/Managerial ControlCeo Jul 31, 2022
Fred Hawkins Individual Corporate DirectorDirector Dec 7, 2023
Dini H Rada Individual Corporate DirectorDirector Aug 22, 2024
Richard K Justice Individual Corporate DirectorDirector Sep 18, 2008
William Chen Individual Corporate DirectorDirector Feb 17, 2022
William a Fields Individual Corporate DirectorDirector Feb 16, 2023
Terry Atchley Individual Corporate DirectorDirector Dec 5, 2013
Witford L Reid Individual Corporate DirectorDirector Aug 22, 2024
Jeffrey Chilson Individual Contracted Managing EmployeeCfo Sep 15, 2025
Corporate OfficerCfo Sep 15, 2025
Operational/Managerial ControlCfo Sep 15, 2025
Timothy Clark Individual Corporate DirectorDirector Dec 8, 2022
Penny Herman Individual W-2 Managing EmployeeDirector of Operations Oct 1, 2010
Thomas Michael Shimshak Individual Corporate DirectorDirector Dec 10, 2020
Adventist Health System Sunbelt Healthcare Corporation Organization, Altamonte Springs, FL Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Mar 1, 2016 100%
William R Jarrett Individual Corporate DirectorDirector Sep 13, 2007
Jennifer J Wandersleben Individual Corporate OfficerChairperson Dec 2, 2021
Corporate DirectorDirector Dec 2, 2021
Timothy Sheehan Individual Corporate DirectorDirector Dec 17, 2009
Catherine Cornelius Individual Corporate DirectorDirector Aug 18, 2005
Richard a Campbell Individual Corporate DirectorDirector Dec 5, 2013
Adventist Health System Sunbelt Inc Organization, Altamonte Springs, FL Corporation, Non-profit 5% Or Greater Direct Ownership Interest Mar 1, 2016 100%

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 88

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 88

NPI Registry JSON

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1013434067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722131",
            "telephone_number": "863-314-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S SCENIC HWY",
            "city": "FROSTPROOF",
            "state": "FL",
            "postal_code": "338432125",
            "telephone_number": "863-546-6384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH SYSTEM-SUNBELT INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVENTIST HEALTH SYSTEM-SUNBELT INC",
        "enumeration_date": "2017-08-29",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "DUNKEL",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "727-942-5002"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVENTHEALTH FAMILY MEDICINE FROSTPROOF",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Frostproof Family Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Frostproof, FL

Sources for this page

Verify at the official NPI Registry.