NPIMap

Organization Active NPI

Leesburg Regional Medical Center Inc

Doing business as Uf Health Emergency/Urgent Care Eustis Mt. Dora

  • Urgent Care Clinic/Center
  • Leesburg, FL
National Provider Identifier
1245001189
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
LEESBURG REGIONAL MEDICAL CENTER INC
Doing business as
Uf Health Emergency/Urgent Care Eustis Mt. Dora
Practice address
600 E Dixie Ave
Leesburg, FL 34748-5925
Phone
(352) 323-5001
NPI assigned
Jan 10, 2024
Last updated
Jan 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Authorized official

Name
Heather Long
Title
Ceo
Phone
(352) 323-5001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

600 E Dixie Ave
Leesburg, FL 34748-5925

Mailing address

600 E Dixie Ave
Leesburg, FL 34748-5925
Phone (352) 323-5001

Other practice location 1

17021 US Highway 441
Mount Dora, FL 32757-6734
Phone (352) 323-5001

Other names 1

  • UF HEALTH EMERGENCY/URGENT CARE EUSTIS MT. DORA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091007000328 FL Part A Provider - Hospital 1254228448 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: The Villages, FL; Tavares, FL; Mount Dora, FL; Leesburg, FL; Clermont, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245001189. Details of each certification follow.

Hospital certification: CCN 100084

Legal name
LEESBURG REGIONAL MEDICAL CENTER INC
Doing business as
UF HEALTH LEESBURG HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Sep 15, 2023
Beds
330
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jul 7, 1961 in FL
Enrollment address
600 East Dixie Avenue
Leesburg, FL 34748-5925
Main/Primary Hospital Location
Hospital subgroups
Acute care, Other

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Uf Health Leesburg HospitalCCN 100084 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Leesburg Reg Med Ctr Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Phil Braun Individual Corporate DirectorSecretary Jan 1, 2022
Kent Fuchs Individual Corporate Director Jan 1, 2020
David Mann Individual Corporate Director Sep 26, 2024
Marsha Powers Individual Corporate Director Jan 1, 2020
Central Florida Health Inc Organization, Leesburg, FL Corporation 5% Or Greater Direct Ownership Interest Mar 3, 2009 100%
Ryan Fuller Individual Corporate Director Dec 13, 2024
Stephen Joel Motew Individual Corporate Director Sep 26, 2024
Todd Neville Individual Corporate Director Sep 26, 2024
Gregory Lewis Individual Corporate Director Apr 1, 2020
Robert Stilley Individual Corporate Director Sep 26, 2024
Heather Long Individual Corporate OfficerCeo Jan 10, 2023
Corporate Director Jan 10, 2023
W-2 Managing Employee Jan 10, 2023
Donald W Landry Individual Corporate Director Sep 1, 2025
Edmund Hunter Beebe Individual Corporate Director Jan 1, 2020
Jennifer Hunt Individual Corporate Director Sep 26, 2024
Samuel John Moore Individual Corporate DirectorTreasurer Oct 10, 2025

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Affiliated clinicians 495

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 495

NPI Registry JSON

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

{
    "created_epoch": "1704844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704844800000",
    "number": "1245001189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485925",
            "telephone_number": "352-323-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485925",
            "telephone_number": "352-323-5001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17021 US Highway 441",
            "address_purpose": "LOCATION",
            "city": "Mount Dora",
            "state": "FL",
            "postal_code": "327576734",
            "country_code": "US",
            "telephone_number": "352-323-5001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEESBURG REGIONAL MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-10",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "352-323-5001"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UF HEALTH EMERGENCY/URGENT CARE EUSTIS MT. DORA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.