NPIMap

Organization Active NPI

Florida Hospital Waterman Inc

Doing business as AdventHealth Waterman

  • Rehabilitation Hospital Unit
  • Ormond Beach, FL
National Provider Identifier
1851940035
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
FLORIDA HOSPITAL WATERMAN INC
Doing business as
AdventHealth Waterman
Practice address
770 W Granada Blvd Ste 203
Ormond Beach, FL 32174-5179
Phone
(352) 253-3333
NPI assigned
Sep 10, 2019
Last updated
Jan 24, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
FLORIDA HOSPITAL WATERMAN INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Authorized official

Name
Andrii Korchuk
Title
Cfo
Phone
(303) 524-5645

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X Primary

Addresses

Primary practice location

770 W Granada Blvd Ste 203
Ormond Beach, FL 32174-5179

Mailing address

1000 Waterman Way
Tavares, FL 32778-5266

Other practice location 1

1000 Waterman Way
Tavares, FL 32778-5266
Phone (352) 253-3333

Other names 1

  • AdventHealth Waterman Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.mettles.com/ Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191111001202 FL Part A Provider - Hospital 7416986864 Practice locations: Tavares, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851940035. Details of each certification follow.

Hospital certification: CCN 10T057

Legal name
FLORIDA HOSPITAL WATERMAN INC
Doing business as
ADVENTHEALTH WATERMAN
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 1992 in FL
Enrollment address
1000 Waterman Way
Tavares, FL 32778-5266
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Adventhealth WatermanCCN 10T057 · All quality measures
Ownership
Non-profit
Certified
Jan 1, 2026

National Provider Directory

National Provider Directory
Tax ID family
Florida Hospital Waterm4 organizations share this tax ID, including this one
Part of
Florida Hospital Waterm

Other organizations with this tax ID 3

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

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 32

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Julian Coomes Individual W-2 Managing EmployeeIp Rehab Director Sep 1, 2020
Operational/Managerial ControlIp Rehab Director Sep 1, 2020
Michele Goeb-Burkett Individual Corporate DirectorDirector Dec 8, 2022
Christine Stewart Individual Corporate DirectorDirector Apr 4, 2024
Debora H Thomas Individual Corporate OfficerAssistant Secretary Aug 24, 2023
Jeffrey Graff Individual Corporate OfficerAssistant Secretary Sep 11, 2014
Andrii Korchuk Individual Contracted Managing EmployeeCfo Dec 1, 2024
Corporate OfficerAssistant Secretary Dec 12, 2024
Operational/Managerial ControlCfo Dec 1, 2024
Thomas L Werner Individual Corporate DirectorDirector Jun 7, 2007
Abel Biri Individual Corporate OfficerBoard Secretary, President Jun 8, 2017
Corporate DirectorDirector Jun 8, 2017
Patricia Elizabeth Smolter Individual Corporate DirectorDirector Apr 6, 2023
Michael Saunders Individual Corporate OfficerAssistant Secretary Feb 26, 2007
Pamela Simmons Individual Corporate DirectorDirector Apr 6, 2023
Marlyne Jean Pierre Individual Corporate DirectorDirector Apr 6, 2023
Brandon Nudd Individual Contracted Managing EmployeeCeo Oct 6, 2025
Corporate OfficerCeo Oct 6, 2025
Operational/Managerial ControlCeo Oct 6, 2025
Barbara Howard Individual Corporate DirectorDirector Dec 17, 2009
Paul C Rathbun Individual Corporate OfficerAssistant Secretary Sep 11, 2014
Susan Caddell Individual Corporate OfficerVice Chair Dec 12, 2024
Corporate DirectorDirector Jan 1, 2018
Adventist Health System Sunbelt Healthcare Corporation Organization, Altamonte Springs, FL Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Oct 1, 2000 100%
Amanda Brady Individual Corporate OfficerAssistant Secretary Feb 27, 2020
Toni Berrios Individual Corporate OfficerAssistant Secretary Dec 8, 2022
David Weiss Individual Corporate DirectorDirector Jun 9, 2011
Haney Vincent Individual Corporate OfficerAssistant Secretary Dec 9, 2021
Michael W Fountain Individual Corporate DirectorDirector Dec 8, 2022
Todd Mazenko Individual Corporate DirectorDirector Jan 1, 2021
Todd a Goodman Individual Corporate OfficerAssistant Secretary Sep 14, 2017
Lorenzo Brown Individual Corporate OfficerVice Chair Mar 28, 2025
Corporate DirectorDirector Mar 27, 2025
David L Huffman Individual Corporate OfficerAssistant Secretary Feb 27, 2020
Robert C Foltz Individual Corporate OfficerAssistant Secretary Sep 11, 2014
Lynn Addiscott Individual Corporate OfficerAssistant Secretary Jan 1, 2000
Fran Crunk Individual Corporate DirectorDirector Aug 21, 2025
Sharlene Curet Individual Corporate DirectorDirector Apr 6, 2023
Gordon Noseworthy Individual Corporate DirectorDirector Apr 6, 2023
Beverly Morgan Individual Corporate OfficerAssistant Secretary Aug 21, 2025

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 85

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 85

Practitioners & affiliated clinicians

Affiliated clinicians 9

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737676800000",
    "number": "1851940035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 W GRANADA BLVD STE 203",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745179",
            "telephone_number": "352-253-3333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Waterman Way",
            "address_purpose": "LOCATION",
            "city": "Tavares",
            "state": "FL",
            "postal_code": "327785266",
            "country_code": "US",
            "telephone_number": "352-253-3333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FLORIDA HOSPITAL WATERMAN INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FLORIDA HOSPITAL WATERMAN INC",
        "enumeration_date": "2019-09-10",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A",
        "authorized_official_last_name": "KORCHUK",
        "authorized_official_first_name": "ANDRII",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "303-524-5645"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "AdventHealth Waterman",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AdventHealth Waterman",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ormond Beach, FL

Sources for this page

Verify at the official NPI Registry.