Sunshine Family Healthcare, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SUNSHINE FAMILY HEALTHCARE, LLC

Practice address

21 Hospital Dr Ste 280
Palm Coast, FL 32164-2456

Phone

(386) 986-6808

Fax

(386) 986-6818

NPI assigned

Jun 17, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jerry Dale Leventhal, MD

Title

Owner / Physician

Phone

(386) 986-6808

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Atlantic Family Medicine PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Sunshine Family Healthcare, LLC

  • Family Medicine Physician
  • Palm Coast, FL
  • NPI 1437744794
  NPD tax ID

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23575/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618185600000",
    "number": "1235174095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 HOSPITAL DR STE 280",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321642456",
            "telephone_number": "386-986-6808",
            "fax_number": "386-986-6818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 HOSPITAL DR STE 280",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321642456",
            "telephone_number": "386-986-6808",
            "fax_number": "386-986-6818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1185 Dunlawton Ave",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Port Orange",
            "state": "FL",
            "postal_code": "321272905",
            "country_code": "US",
            "telephone_number": "386-767-5477",
            "fax_number": "386-767-5580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUNSHINE FAMILY HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2021-04-12",
        "certification_date": "2021-03-05",
        "status": "A",
        "authorized_official_last_name": "LEVENTHAL",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OWNER / PHYSICIAN",
        "authorized_official_telephone_number": "386-986-6808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300519400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15598000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremy Charles Stultz I
• Rommelle Von Such, M.D.
• Breelyn Sugden
• Allyson Rae Suit, D.D.S.
• Jonathan M Sullivan, D.P.M.
• Sunshine Family Healthcare, LLC
• Sunshine Psychiatric Care LLC
• Susies Home LLC (Susie's Home)
• Robin Susser, PH.D.
• Sustainable Rehabilitation LLC

• Family Medicine Physician in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.