Organization Active NPI

Andrews Institute ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Gulf Breeze, FL
National Provider Identifier
1104907328
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ANDREWS INSTITUTE ASC LLC
Practice address
1040 Gulf Breeze Parkway
Suite 100
Gulf Breeze, FL 32561
Phone
(850) 916-8500
Fax
(850) 916-8509
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Joseph L Story, MD
Title
Chairman of Board of Managers
Phone
(850) 469-2338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X FL Primary

Addresses

Primary practice location

1040 Gulf Breeze Parkway
Suite 100
Gulf Breeze, FL 32561

Mailing address

1040 Gulf Breeze Parkway
Suite 100
Gulf Breeze, FL 32561
Phone (850) 916-8500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070530000095 FL Part B Supplier - Ambulatory Surgical Center 5698872554 Practice locations: Gulf Breeze, FL

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Andrews Institute Ambulatory Surgery CenterCCN 10C0001490
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1066283Andrews Institute ASC LLC1040 Gulf Breeze Parkway Ste 100, Gulf Breeze, FL 32561Certificate of waiverMar 20, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1040 Gulf Breeze Pkwy
Ste 100
Gulf Breeze, FL 32561
Phone (850) 916-8500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104907328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 GULF BREEZE PARKWAY",
            "address_2": "SUITE 100",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "32561",
            "telephone_number": "850-916-8500",
            "fax_number": "850-916-8509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 GULF BREEZE PARKWAY",
            "address_2": "SUITE 100",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "32561",
            "telephone_number": "850-916-8500",
            "fax_number": "850-916-8509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREWS INSTITUTE ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STORY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHAIRMAN OF BOARD OF MANAGERS",
        "authorized_official_telephone_number": "850-469-2338",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.