NPIMap

Organization Active NPI

Adventist Health Systems Sunbelt Inc

Doing business as Loch Haven OB/GYN

  • Obstetrics & Gynecology Physician
  • Orlando, FL
National Provider Identifier
1720172224
Registry record updated Dec 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
ADVENTIST HEALTH SYSTEMS SUNBELT INC
Doing business as
Loch Haven OB/GYN
Practice address
235 E. Princeton St
Suite 200
Orlando, FL 32804
Phone
(407) 303-1444
Fax
(407) 303-1446
NPI assigned
Oct 2, 2006
Last updated
Dec 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2015

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

Authorized official

Name
Mr. Daryl Tol
Title
President/Ced
Phone
(407) 303-1531

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Primary

Addresses

Primary practice location

235 E. Princeton St
Suite 200
Orlando, FL 32804

Mailing address

235 E.Princeton St
Suite 200
Orlando, FL 32804
Phone (407) 303-1444

Other identifiers 5

IdentifierTypeStateIssuer
0476716OtherFLAETNA HMO EPO
010129012MedicaidFL
4578757OtherFLAETNA PPO
CB 1994OtherFLMEDICARE RAILROAD
97809OtherFLBLUE CROSS

Other names 1

  • Loch Haven OB/GYN Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040505000557 FL Part B Supplier - Clinic/Group Practice 4082602214 Receives reassigned benefits from 84 practitioners
15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winter Garden, FL; Winter Park, FL; Orlando, FL

Other NPIs on the same Medicare enrollment 15

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

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Sunbelt Living Ctr Apop64 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 29

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 29

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451433600000",
    "number": "1720172224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 E.PRINCETON ST",
            "address_2": "SUITE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32804",
            "telephone_number": "407-303-1444",
            "fax_number": "407-303-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E. PRINCETON ST",
            "address_2": "SUITE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32804",
            "telephone_number": "407-303-1444",
            "fax_number": "407-303-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH SYSTEMS SUNBELT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2015-12-30",
        "status": "A",
        "authorized_official_last_name": "TOL",
        "authorized_official_first_name": "DARYL",
        "authorized_official_title_or_position": "PRESIDENT/CED",
        "authorized_official_telephone_number": "407-303-1531",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO EPO",
            "identifier": "0476716",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010129012",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4578757",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CB 1994",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "97809",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Loch Haven OB/GYN",
            "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 Dec 30, 2015; 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.