NPIMap

Organization Active NPI

Adventist Health System-Sunbelt Inc

Doing business as AdventHealth Family Medicine Wauchula

  • Rural Health Clinic/Center
  • Wauchula, FL
National Provider Identifier
1396046637
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
4239 Issued in FL
Legal business name
ADVENTIST HEALTH SYSTEM-SUNBELT INC
Doing business as
AdventHealth Family Medicine Wauchula
AdventHealth Medical Group OB GYN at Okeechobee
Florida Hospital Wauchula Pioneer Medical Center
Practice address
515 Carlton St
Wauchula, FL 33873-3407
Phone
(863) 773-6606
Fax
(863) 773-9542
NPI assigned
Nov 3, 2010
Last updated
Oct 10, 2025By 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 Oct 10, 2025

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

Authorized official

Name
Jason Dunkel
Title
Ceo
Phone
(727) 942-5002

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 4239 FL Primary
Medical Physician Assistant 363AM0700X 4239 FL
Family Medicine Physician 207Q00000X 4239 FL
Obstetrics & Gynecology Physician 207V00000X 4239 FL

Addresses

Primary practice location

515 Carlton St
Wauchula, FL 33873-3407

Mailing address

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

Other names 3

  • AdventHealth Family Medicine Wauchula Doing business as
  • AdventHealth Medical Group OB GYN at Okeechobee Doing business as
  • Florida Hospital Wauchula Pioneer Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080726000012 FL Part B Supplier - Clinic/Group Practice 0749232445 Receives reassigned benefits from 300 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Frostproof, FL; Wauchula, FL
O20101129000427 FL Part A Provider - Rural Health Clinic 0749232445 Practice locations: Wauchula, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396046637. Details of each certification follow.

Rural health clinic certification: CCN 103448

Legal name
ADVENTIST HEALTH SYSTEM-SUNBELT INC
Doing business as
ADVENTHEALTH FAMILY MEDICINE WAUCHULA
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 1, 2010
Last certification
Jul 26, 2021
Ownership / control type
2B
Organization structure
OtherNon-profit
Incorporated
May 2, 1973 in FL
Enrollment address
515 Carlton St
Wauchula, FL 33873-3407
Related CCNs
101300

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Part of
Florida Hosp Heartland

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Terrence S Delikat Individual OtherMedical Director Jan 1, 2025
Jason Dunkel Individual Contracted Managing Employee Jul 31, 2022
Corporate OfficerBoard Secretary Dec 8, 2022
Corporate DirectorDirector Aug 25, 2022
Operational/Managerial ControlCeo Jul 31, 2022
Fred Hawkins Individual Corporate DirectorDirector Dec 7, 2023
Dini H Rada Individual Corporate DirectorDirector Aug 22, 2024
Richard K Justice Individual Corporate DirectorDirector Sep 18, 2008
William Chen Individual Corporate DirectorDirector Feb 17, 2022
William a Fields Individual Corporate DirectorDirector Feb 16, 2023
Terry Atchley Individual Corporate DirectorDirector Dec 5, 2013
Witford L Reid Individual Corporate DirectorDirector Aug 22, 2024
Jeffrey Chilson Individual Contracted Managing EmployeeCfo Sep 15, 2025
Corporate OfficerCfo Sep 15, 2025
Operational/Managerial ControlCfo Sep 15, 2025
Timothy Clark Individual Corporate DirectorDirector Dec 8, 2022
Penny Herman Individual W-2 Managing EmployeeDirector of Operations Oct 1, 2010
Thomas Michael Shimshak Individual Corporate DirectorDirector Dec 10, 2020
Adventist Health System Sunbelt Healthcare Corporation Organization, Altamonte Springs, FL Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Nov 1, 1982 100%
William R Jarrett Individual Corporate DirectorDirector Sep 13, 2007
Jennifer J Wandersleben Individual Corporate OfficerChairperson Dec 2, 2021
Corporate DirectorDirector Dec 2, 2021
Timothy Sheehan Individual Corporate DirectorDirector Dec 17, 2009
Catherine Cornelius Individual Corporate DirectorDirector Aug 18, 2005
Richard a Campbell Individual Corporate DirectorDirector Dec 5, 2013
Adventist Health System Sunbelt Inc Organization, Altamonte Springs, FL Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 1, 2010 100%

Owners & managing parties with NPI records 5

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

Facilities with the same owner 88

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 88

Practitioners & affiliated clinicians

Practitioners 134

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 134

NPI Registry JSON

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

{
    "created_epoch": "1288742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760054400000",
    "number": "1396046637",
    "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": "515 CARLTON ST",
            "city": "WAUCHULA",
            "state": "FL",
            "postal_code": "338733407",
            "telephone_number": "863-773-6606",
            "fax_number": "863-773-9542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH SYSTEM-SUNBELT INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVENTIST HEALTH SYSTEM-SUNBELT INC",
        "enumeration_date": "2010-11-03",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A",
        "authorized_official_last_name": "DUNKEL",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "727-942-5002"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "FL",
            "license": "4239",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "4239",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "4239",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "4239",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AdventHealth Family Medicine Wauchula",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AdventHealth Medical Group OB GYN at Okeechobee",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Florida Hospital Wauchula Pioneer Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Florida Hospital Wauchula Pioneer Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wauchula, FL

Sources for this page

Verify at the official NPI Registry.