Organization Active NPI

Vantage Health, LLC

Doing business as Vantage Urologic Institute

  • Urology Physician
  • Ocala, FL
National Provider Identifier
1649509878
Registry record updated May 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
VANTAGE HEALTH, LLC
Doing business as
Vantage Urologic Institute
Practice address
9401 SW Highway 200 Ste 502
Ocala, FL 34481-9650
Phone
(352) 671-4488
Fax
(352) 854-5726
NPI assigned
Dec 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2018

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

Authorized official

Name
Donald Russell Locke, MDNPI 1497703912
Title
Managing Member
Phone
(352) 861-2115

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

9401 SW Highway 200 Ste 502
Ocala, FL 34481-9650

Mailing address

PO Box 773730
Ocala, FL 34477-3730
Phone (352) 861-2115

Other practice location 1

4600 SW 46th Ct
Suite 160
Ocala, FL 34474-5708
Phone (352) 861-2115

Other names 1

  • Vantage Urologic Institute Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100311001010 FL Part B Supplier - Clinic/Group Practice 0749315083 Receives reassigned benefits from 8 practitioners
Practice locations: Ocala, FL

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2003027Vantage Urologic Institute9401 SW Highway 200, Ste 502, Ocala, FL 34481Certificate of waiverJan 31, 2028
10D2004804Vantage Urologic Institute9401 SW Highway 200 Ste 502, Ocala, FL 34481AccreditationNov 13, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1261008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525737600000",
    "number": "1649509878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 773730",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344773730",
            "telephone_number": "352-861-2115",
            "fax_number": "352-854-5726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 SW HIGHWAY 200 STE 502",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344819650",
            "telephone_number": "352-671-4488",
            "fax_number": "352-854-5726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 SW 46th Ct",
            "address_2": "Suite 160",
            "address_purpose": "LOCATION",
            "city": "Ocala",
            "state": "FL",
            "postal_code": "344745708",
            "country_code": "US",
            "telephone_number": "352-861-2115",
            "fax_number": "352-854-5726",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VANTAGE HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-17",
        "last_updated": "2018-05-08",
        "status": "A",
        "authorized_official_last_name": "LOCKE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "352-861-2115",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vantage Urologic Institute",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vantage Urologic Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; 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.