Adventhealth Surgery Center Innovation Tower, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ADVENTHEALTH SURGERY CENTER INNOVATION TOWER, LLC

Practice address

265 E. Rollins Street
4TH Floor Suite 4500
Orlando, FL 32804

Phone

(407) 200-3706

NPI assigned

Aug 26, 2022

Last updated

Jun 29, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patty Shoults, MBA, BSN, RN CNOR, C

Title

Executive Director

Phone

(407) 200-3706

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Advent Health Surgery Center Innovation Tower LLCCCN 10C0001732

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

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)

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687996800000",
    "number": "1346969789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 E. ROLLINS STREET",
            "address_2": "4TH FLOOR SUITE 4500",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 E. ROLLINS STREET",
            "address_2": "4TH FLOOR SUITE 4500",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32804",
            "telephone_number": "407-200-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTHEALTH SURGERY CENTER INNOVATION TOWER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-26",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A",
        "authorized_official_last_name": "SHOULTS",
        "authorized_official_first_name": "PATTY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "407-200-3706",
        "authorized_official_credential": "MBA, BSN, RN CNOR, C"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "cloud-based",
            "affiliation": "N",
            "address_1": "265 E. Rollins Street",
            "address_2": "4th Floor Suite 4500",
            "city": "Orlando",
            "state": "FL",
            "country_code": "US",
            "postal_code": "32804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Advent Care Transportation, LLC
• Advent Health
• Advent Healthcare
• Adventhealth Imaging Center Innovation
• Adventhealth Imaging Training Center
• Adventhealth Surgery Center Mills Park LLC (AdventHealth Surgery Center Mills Park)
• Adventhealth VC Services LLC
• Adventist Care Centers Courtland Inc (AdventHealth Care Center Orlando North)
• Adventist Health System Sunbelt Inc (Florida Hospital)
• Adventist Health System Sunbelt Inc (Florida Hospital Sports Concussion Program)

• Ambulatory Surgical Clinic/Center in Orlando, FL
• Providers in Orlando, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.