Active NPI
Carl Leonidas Loveridge, PA-C
- Physician Assistant
- Orlando, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9104074
- Practice address
- 601 E Rollins St
Orlando, FL 32803 - Phone
- (407) 303-7283
- Fax
- (407) 303-0347
- NPI assigned
- Jun 12, 2006
- Last updated
- Aug 23, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9104074 | FL | Primary |
Addresses
Primary practice location
601 E Rollins St
Orlando, FL 32803
Mailing address
601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-7283
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 292583400 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9104074 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phoebe Dorminy Kids Health | Current | Accepting new patients | |
| Florida Hospital Medical Group Inc | Physician Assistant | Current | Accepting new patients |
| Florida Hospital Medical Group Inc | Current | Accepting new patients | |
| Phoebe Physician Group, Inc | Current | Accepting new patients | |
| Northwest Emergency Physicians LLC | Past | Accepting new patients |
Locations
900 Hope Way
Forest City, FL 32714
Phone (407) 357-1255
2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700
601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996
3100 E Fletcher Ave
#C
Tampa, FL 33613
2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802
500 W 3rd Ave
Ste 101
Albany, GA 31701
Phone (229) 312-5802
151 Mayo St
Ste B
Americus, GA 31709
Phone (229) 928-2900
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Interoperability endpoints
- cloveridge616867@adventhealth.direct-ci.com
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba AdventHealth Medical Group
- Family Medicine Physician
- Orlando, FL
- NPI 1225034234
Physician Assistant
-
- Clinic/Center
- Albany, GA
- NPI 1487899464
-
dba Citrus Pulmonary Consultants
- Pulmonary Disease Physician
- Crystal River, FL
- NPI 1750318192
-
dba Rothman Orthopaedics AdventHealth Medical Group at Minneola
- Prosthetic/Orthotic Supplier
- Minneola, FL
- NPI 1285591545
-
- Clinic/Center
- Fitzgerald, GA
- NPI 1144501867
-
dba Nep
- Emergency Medicine Physician
- Arlington, WA
- NPI 1235172370
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Adventhealth Port Charlotte
- General Acute Care Hospital
- Port Charlotte, FL
- NPI 1760299093
-
dba AdventHealth Tampa
- General Acute Care Hospital
- Tampa, FL
- NPI 1053321919
-
dba AdventHealth Tampa Outreach Laboratory
- Clinical Medical Laboratory
- Tampa, FL
- NPI 1134766694
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534982400000",
"number": "1881636272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 E ROLLINS ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328031248",
"telephone_number": "407-303-7283",
"fax_number": "407-303-0347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 E ROLLINS ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "32803",
"telephone_number": "407-303-7283",
"fax_number": "407-303-0347"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOVERIDGE",
"first_name": "CARL",
"middle_name": "LEONIDAS",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2018-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9104074",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "292583400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
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 Aug 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.