NPIMap

Organization Active NPI

Atlantis Urgent Care, LLC

Doing business as Atlantis Urgent Care

  • Urgent Care Clinic/Center
  • Indian Harbour Beach, FL
National Provider Identifier
1821280579
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
602309 Issued in FL
Legal business name
ATLANTIS URGENT CARE, LLC
Doing business as
Atlantis Urgent Care
Practice address
2254 Highway A1A
Indian Harbour Beach, FL 32937-4922
Phone
(321) 777-2273
Fax
(321) 779-7425
NPI assigned
Aug 16, 2007
Last updated
Mar 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Authorized official

Name
Dr. Bjorn Dimberg, M.D.NPI 1417950809
Title
President
Phone
(321) 777-2273

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
Urgent Care Clinic/Center 261QU0200X 602309 FL Primary

Addresses

Primary practice location

2254 Highway A1A
Indian Harbour Beach, FL 32937-4922

Mailing address

2254 Highway A1A
Indian Harbour Beach, FL 32937-4922
Phone (321) 777-2273

Other identifiers 1

IdentifierTypeStateIssuer
K4296OtherFLMEDICARE PROVIDER ID

Other names 2

  • Atlantis Urgent Care Doing business as
  • Adena Medical Services Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050119000870 FL Part B Supplier - Clinic/Group Practice 6305895111 Receives reassigned benefits from 18 practitioners
Practice locations: Indian Harbour Beach, FL

National Provider Directory

National Provider Directory

Locations

6300 N Wickham Rd
Melbourne, FL 32940
Phone (321) 622-4097

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680220800000",
    "number": "1821280579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2254 HIGHWAY A1A",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329374922",
            "telephone_number": "321-777-2273",
            "fax_number": "321-779-7425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2254 HIGHWAY A1A",
            "city": "INDIAN HARBOUR BEACH",
            "state": "FL",
            "postal_code": "329374922",
            "telephone_number": "321-777-2273",
            "fax_number": "321-779-7425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIS URGENT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-16",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A",
        "authorized_official_last_name": "DIMBERG",
        "authorized_official_first_name": "BJORN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-777-2273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "FL",
            "license": "602309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER ID",
            "identifier": "K4296",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlantis Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Adena Medical Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Indian Harbour Beach, FL

Sources for this page

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