NPIMap

Organization Active NPI

Adventist Health System-Sunbelt Inc

Doing business as AdventHealth Medical Group Breast Surgery, Ear Nose & Throat, General Surgery at Sun N Lake

  • Internal Medicine Physician
  • Sebring, FL
National Provider Identifier
1164698809
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ADVENTIST HEALTH SYSTEM-SUNBELT INC
Doing business as
AdventHealth Medical Group Breast Surgery, Ear Nose & Throat, General Surgery at Sun N Lake
AdventHealth Medical Group Cardiology at Lake Placid
AdventHealth Medical Group Family Medicine at Lake Placid9 more in Other names
Practice address
4200 Sun N Lake Blvd
Sebring, FL 33872-1986
Phone
(863) 402-3366
Fax
(863) 402-3110
NPI assigned
May 2, 2008
Last updated
Jan 31, 2023By 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 Jan 31, 2023

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

Authorized official

Name
Nathan Thomason
Title
Cfo
Phone
(863) 402-3366

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Family Nurse Practitioner 363LF0000X
Obstetrics & Gynecology Nurse Practitioner 363LX0001X
Clinical Social Worker 1041C0700X
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X
Gastroenterology Physician 207RG0100X
Infectious Disease Physician 207RI0200X
Pulmonary Disease Physician 207RP1001X
Obstetrics & Gynecology Physician 207V00000X
Pediatrics Physician 208000000X
Surgery Physician 208600000X
Vascular Surgery Physician 2086S0129X
Hospitalist Physician 208M00000X

Addresses

Primary practice location

4200 Sun N Lake Blvd
Sebring, FL 33872-1986

Mailing address

4200 Sun N Lake Blvd
Sebring, FL 33872-1986
Phone (863) 402-3366

Other names 12

  • AdventHealth Medical Group Breast Surgery, Ear Nose & Throat, General Surgery at Sun N Lake Doing business as
  • AdventHealth Medical Group Cardiology at Lake Placid Doing business as
  • AdventHealth Medical Group Family Medicine at Lake Placid Doing business as
  • AdventHealth Medical Group General & Vascular Surgery at Lake Placid Doing business as
  • AdventHealth Medical Group General Surgery & Vascular Surgery at Sun N Lake Doing business as
  • AdventHealth Medical Group Interventional Cardiology at Sun N Lake Doing business as
  • AdventHealth Medical Group OB GYN at Sebring Doing business as
  • AdventHealth Medical Group OB GYN at Sun N Lake Doing business as
  • AdventHealth Medical Group Pulmonology & Critical Care at Sun N Lake Doing business as
  • AdventHealth Medical Group Urology at Lake Placid Doing business as
  • AdventHealth Medical Group Urology at Sun N Lake Doing business as
  • Florida Hospital Heartland Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080401000861 FL Part B Supplier - Clinic/Group Practice 0749232445 Receives reassigned benefits from 358 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sebring, FL; Lake Placid, FL; Avon Park, FL

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Erick Calderon MD

Locations

1346 US Highway 27 N
Lake Placid, FL 33852
Phone (863) 465-3040

2950 Alt US Hwy 27 S
Ste B
Sebring, FL 33870
Phone (863) 402-3429

37 Ryant Blvd
Sebring, FL 33870
Phone (863) 382-4894

4023 Sun N Lake Blvd
Ste A
Sebring, FL 33872

4121 Sun N LK Blvd Ste a
Sebring, FL 33872

4233 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 382-1570

4240 Sun N Lake Blvd
Ste 1
Sebring, FL 33872

4240 Sun N Lake Blvd
Ste 202
Sebring, FL 33872
Phone (863) 471-3926

4301 Sun N Lake Blvd
Ste 102
Sebring, FL 33872
Phone (863) 402-3161

4325 Sun N Lake Blvd
Ste 150
Sebring, FL 33872

4409 Sun N Lake Blvd
Ste E
Sebring, FL 33872
Phone (863) 314-0001

4421 Sun N Lake Blvd
Ste A
Sebring, FL 33872
Phone (863) 314-4357

6325 US 27 N
Ste 201
Sebring, FL 33870
Phone (863) 382-9600

6325 US 27 N
Ste 202
Sebring, FL 33870
Phone (863) 471-3926

10987 Sheldon Rd
Ste 200
Tampa, FL 33626
Phone (813) 467-4800

423 Carlton St
Wauchula, FL 33873

431 Carlton St
Wauchula, FL 33873
Phone (863) 767-1019

465 Carlton St
Wauchula, FL 33873

520 Carlton St
Wauchula, FL 33873
Phone (863) 767-6203

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 315

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 315

NPI Registry JSON

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

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675123200000",
    "number": "1164698809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338721986",
            "telephone_number": "863-402-3366",
            "fax_number": "863-402-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338721986",
            "telephone_number": "863-402-3366",
            "fax_number": "863-402-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH SYSTEM-SUNBELT INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVENTIST HEALTH SYSTEM-SUNBELT INC",
        "enumeration_date": "2008-05-02",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A",
        "authorized_official_last_name": "THOMASON",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "863-402-3366"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AdventHealth Medical Group Breast Surgery, Ear Nose & Throat, General Surgery at Sun N Lake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AdventHealth Medical Group Cardiology at Lake Placid",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AdventHealth Medical Group Family Medicine at Lake Placid",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AdventHealth Medical Group General & Vascular Surgery at Lake Placid",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AdventHealth Medical Group General Surgery & Vascular Surgery at Sun N Lake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AdventHealth Medical Group Interventional Cardiology at Sun N Lake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AdventHealth Medical Group OB GYN at Sebring",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AdventHealth Medical Group OB GYN at Sebring",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AdventHealth Medical Group OB GYN at Sun N Lake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AdventHealth Medical Group Pulmonology & Critical Care at Sun N Lake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AdventHealth Medical Group Urology at Lake Placid",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AdventHealth Medical Group Urology at Sun N Lake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Florida Hospital Heartland Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sebring, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.