NPIMap

Organization Active NPI

Adventist Health System-Sunbelt Inc

Doing business as AdventHealth Medical Group Cardiology & Vascular Medicine at Wauchula

  • Family Medicine Physician
  • Wauchula, FL
National Provider Identifier
1578725941
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ADVENTIST HEALTH SYSTEM-SUNBELT INC
Doing business as
AdventHealth Medical Group Cardiology & Vascular Medicine at Wauchula
AdventHealth Medical Group OB GYN at Wauchula
Florida Hospital Wauchula
Practice address
524 Carlton St
Wauchula, FL 33873-3408
Phone
(863) 402-3366
Fax
(863) 402-3110
NPI assigned
Jun 27, 2008
Last updated
Jan 31, 2023By 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 Jan 31, 2023

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

Authorized official

Name
Nathan Thomason
Title
Cfo
Phone
(863) 402-3366

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Obstetrics & Gynecology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LX0001X

Addresses

Primary practice location

524 Carlton St
Wauchula, FL 33873-3408

Mailing address

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

Other names 3

  • AdventHealth Medical Group Cardiology & Vascular Medicine at Wauchula Doing business as
  • AdventHealth Medical Group OB GYN at Wauchula Doing business as
  • Florida Hospital Wauchula Doing business as

Medicare participation

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

Enrollment records 1

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
Practice locations: Frostproof, FL; Wauchula, FL

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
Walker Memorial Medical

Locations

463 Carlton St
Wauchula, FL 33873
Phone (863) 767-0522

Practitioners & affiliated clinicians

Practitioners 303

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 303

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675123200000",
    "number": "1578725941",
    "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": "524 CARLTON ST",
            "city": "WAUCHULA",
            "state": "FL",
            "postal_code": "338733408",
            "telephone_number": "863-402-3366",
            "fax_number": "863-402-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH SYSTEM-SUNBELT INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVENTIST HEALTH SYSTEM-SUNBELT INC",
        "enumeration_date": "2008-06-27",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A",
        "authorized_official_last_name": "THOMASON",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "863-402-3366"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AdventHealth Medical Group Cardiology & Vascular Medicine at Wauchula",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AdventHealth Medical Group OB GYN at Wauchula",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Florida Hospital Wauchula",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Florida Hospital Wauchula",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wauchula, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.