NPIMap

Organization Active NPI

Osceola Surgical Associates LLC

  • Plastic Surgery Physician
  • Kissimmee, FL
National Provider Identifier
1801558622
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
OSCEOLA SURGICAL ASSOCIATES LLC
Practice address
720 W Oak St Ste 370
Kissimmee, FL 34741-4910
Phone
(407) 487-8333
NPI assigned
Oct 8, 2021
Organization subpart
Yes
Parent organization
OSCEOLA SURGICAL ASSOCIATES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Authorized official

Name
William Tedrick Johnson
Title
Vice President
Phone
(615) 372-3375

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

720 W Oak St Ste 370
Kissimmee, FL 34741-4910

Mailing address

2000 Health Park Dr
Brentwood, TN 37027-4692
Phone (615) 372-5426

National Provider Directory

National Provider Directory
Tax ID family
Osceola Surgical Associates LLC4 organizations share this tax ID, including this one
Part of
Osceola Surgical Associates LLC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633651200000",
    "number": "1801558622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274692",
            "telephone_number": "615-372-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W OAK ST STE 370",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414910",
            "telephone_number": "407-487-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSCEOLA SURGICAL ASSOCIATES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OSCEOLA SURGICAL ASSOCIATES LLC",
        "enumeration_date": "2021-10-08",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TEDRICK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-372-3375"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.