NPIMap

Organization Active NPI

Adventist Health System/Sunbelt, Inc.

  • Family Medicine Physician
  • Orlando, FL
National Provider Identifier
1578050704
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ADVENTIST HEALTH SYSTEM/SUNBELT, INC.
Practice address
630 N Bumby Ave
Orlando, FL 32803-4917
Phone
(407) 894-3521
NPI assigned
Apr 13, 2018
Organization subpart
Yes
Parent organization
ADVENTIST HEALTH SYSTEM/SUNBELT, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Authorized official

Name
Scott C. Brady, MD
Title
President
Phone
(407) 200-2300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X FL Primary

Addresses

Primary practice location

630 N Bumby Ave
Orlando, FL 32803-4917

Mailing address

2600 Westhall LN Ste 300
Maitland, FL 32751-7107
Phone (407) 200-2300

Other identifiers 1

IdentifierTypeStateIssuer
DL090BOtherFLMEDICARE

Other names 1

  • AdventHealth Total Health Management - Colonial Town Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100903000981 FL Part B Supplier - Clinic/Group Practice 3274657721 Receives reassigned benefits from 115 practitioners
35 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wesley Chapel, FL; Palm Coast, FL; Palm Harbor, FL; Port Orange, FL; Saint Cloud, FL; Oviedo, FL; Sanford, FL; Spring Hill, FL…

Other NPIs on the same Medicare enrollment 35

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

View all 35

National Provider Directory

National Provider Directory
Part of
Adventist Health Systemsunbelt Inc

NPI Registry JSON

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

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587340800000",
    "number": "1578050704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 WESTHALL LN STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517107",
            "telephone_number": "407-200-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N BUMBY AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328034917",
            "telephone_number": "407-894-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH SYSTEM/SUNBELT, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVENTIST HEALTH SYSTEM/SUNBELT, INC.",
        "enumeration_date": "2018-04-13",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-200-2300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "DL090B",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AdventHealth Total Health Management - Colonial Town",
            "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 Apr 20, 2020; 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.