NPIMap

Organization Active NPI

Adventist Health System Sunbelt Inc

  • Sports Medicine (Family Medicine) Physician
  • Orlando, FL
National Provider Identifier
1275901951
Registry record updated Sep 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
Legal business name
ADVENTIST HEALTH SYSTEM SUNBELT INC
Practice address
7975 Lake Underhill Rd
Suite 200
Orlando, FL 32822-8202
Phone
(407) 303-8012
NPI assigned
Sep 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2015

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

Authorized official

Name
Mr. Henderson Peter
Title
Director
Phone
(407) 200-2227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X Primary

Addresses

Primary practice location

7975 Lake Underhill Rd
Suite 200
Orlando, FL 32822-8202

Mailing address

7975 Lake Underhill Rd
Suite 200
Orlando, FL 32822-8202
Phone (407) 303-8012

Other names 1

  • Florida Hospital Sports Concussion Program Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040505000557 FL Part B Supplier - Clinic/Group Practice 4082602214 Receives reassigned benefits from 84 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winter Garden, FL; Winter Park, FL; Orlando, FL

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1441929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441929600000",
    "number": "1275901951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7975 LAKE UNDERHILL RD",
            "address_2": "SUITE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328228202",
            "telephone_number": "407-303-8012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7975 LAKE UNDERHILL RD",
            "address_2": "SUITE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328228202",
            "telephone_number": "407-303-8012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH SYSTEM SUNBELT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-11",
        "last_updated": "2015-09-11",
        "status": "A",
        "authorized_official_last_name": "PETER",
        "authorized_official_first_name": "HENDERSON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "407-200-2227",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Florida Hospital Sports Concussion Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; 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.