NPIMap

Organization Active NPI

Adventist Health System-Sunbelt Inc

Doing business as Adventhealth Family and Lifestyle Medicine Avon Park

  • Rural Health Clinic/Center
  • Avon Park, FL
National Provider Identifier
1881850956
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
4171 Issued in FL
Legal business name
ADVENTIST HEALTH SYSTEM-SUNBELT INC
Doing business as
Adventhealth Family and Lifestyle Medicine Avon Park
AdventHealth Family Medicine Avon Park
Florida Hospital Heartland Medical Center Family Practice Center
Practice address
1006 W Pleasant St
Avon Park, FL 33825-2966
Phone
(863) 453-3121
Fax
(863) 452-2823
NPI assigned
Jul 29, 2008
Last updated
Oct 10, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVENTIST HEALTH SYSTEM-SUNBELT INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Authorized official

Name
Jason Dunkel
Title
Ceo
Phone
(863) 402-3366

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X 4171 FL
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 4171 FL
Rural Health Clinic/Center 261QR1300X 4171 FL Primary
Medical Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363AM0700X 4171 FL

Addresses

Primary practice location

1006 W Pleasant St
Avon Park, FL 33825-2966

Mailing address

4200 Sun N Lake Blvd
Sebring, FL 33872-1986
Phone (863) 402-3366

Other names 3

  • ADVENTHEALTH FAMILY AND LIFESTYLE MEDICINE AVON PARK Doing business as
  • AdventHealth Family Medicine Avon Park Doing business as
  • Florida Hospital Heartland Medical Center Family Practice Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080401000861 FL Part B Supplier - Clinic/Group Practice 0749232445 Receives reassigned benefits from 358 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sebring, FL; Lake Placid, FL; Avon Park, FL
O20101119000084 FL Part A Provider - Rural Health Clinic 0749232445 Practice locations: Avon Park, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881850956. Details of each certification follow.

Rural health clinic certification: CCN 103449

Legal name
ADVENTIST HEALTH SYSTEM-SUNBELT INC
Doing business as
ADVENTHEALTH FAMILY AND LIFESTYLE MEDICINE AVON PARK
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 1, 2010
Last certification
Aug 15, 2019
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
1006 W Pleasant St
Avon Park, FL 33825-2966
Related CCNs
100109

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

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Part of
Walker Memorial Medical

Locations

1006 W Pleasant St
Avon Park, FL 33825
Phone (863) 453-3121

2950 Alt US Hwy 27 S
Sebring, FL 33870
Phone (863) 402-1266

2950 US 27
Ste B
Sebring, FL 33870

4200 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-4406

4200 Sun N Lake Blvd
Ste B
Sebring, FL 33872

4240 Sun N Lake Blvd
Ste 202
Sebring, FL 33872
Phone (863) 471-3926

4409 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-0001

4638 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 386-0055

515 Carlton St
Wauchula, FL 33873
Phone (863) 773-6606

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Jason Dunkel Individual Contracted Managing Employee Jul 31, 2022
Corporate OfficerBoard Secretary Dec 8, 2022
Corporate DirectorDirector Aug 25, 2022
Operational/Managerial ControlCeo Jul 31, 2022
Fred Hawkins Individual Corporate DirectorDirector Dec 7, 2023
Dini H Rada Individual Corporate DirectorDirector Aug 22, 2024
Richard K Justice Individual Corporate DirectorDirector Sep 18, 2008
William Chen Individual Corporate DirectorDirector Feb 17, 2022
William a Fields Individual Corporate DirectorDirector Feb 16, 2023
Terry Atchley Individual Corporate DirectorDirector Dec 5, 2013
Witford L Reid Individual Corporate DirectorDirector Aug 22, 2024
Jeffrey Chilson Individual Contracted Managing EmployeeCfo Sep 15, 2025
Corporate OfficerCfo Sep 15, 2025
Operational/Managerial ControlCfo Sep 15, 2025
Timothy Clark Individual Corporate DirectorDirector Dec 8, 2022
Penny Herman Individual W-2 Managing EmployeeDirector of Operations Oct 1, 2010
Thomas Michael Shimshak Individual Corporate DirectorDirector Dec 10, 2020
Adventist Health System Sunbelt Healthcare Corporation Organization, Altamonte Springs, FL Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Nov 1, 1982 100%
William R Jarrett Individual Corporate DirectorDirector Sep 13, 2007
Jennifer J Wandersleben Individual Corporate OfficerChairperson Dec 2, 2021
Corporate DirectorDirector Dec 2, 2021
Timothy Sheehan Individual Corporate DirectorDirector Dec 17, 2009
Catherine Cornelius Individual Corporate DirectorDirector Aug 18, 2005
Richard a Campbell Individual Corporate DirectorDirector Dec 5, 2013
Adventist Health System Sunbelt Inc Organization, Altamonte Springs, FL Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 15, 1997 100%

Owners & managing parties with NPI records 4

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

Facilities with the same owner 88

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

View all 88

Practitioners & affiliated clinicians

Practitioners 74

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 74

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760054400000",
    "number": "1881850956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 SUN N LAKE BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338721986",
            "telephone_number": "863-402-3366",
            "fax_number": "863-402-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 W PLEASANT ST",
            "city": "AVON PARK",
            "state": "FL",
            "postal_code": "338252966",
            "telephone_number": "863-453-3121",
            "fax_number": "863-452-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH SYSTEM-SUNBELT INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVENTIST HEALTH SYSTEM-SUNBELT INC",
        "enumeration_date": "2008-07-29",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A",
        "authorized_official_last_name": "DUNKEL",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "863-402-3366"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "4171",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "4171",
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "FL",
            "license": "4171",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "4171",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVENTHEALTH FAMILY AND LIFESTYLE MEDICINE AVON PARK",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AdventHealth Family Medicine Avon Park",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AdventHealth Family Medicine Avon Park",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Florida Hospital Heartland Medical Center Family Practice Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Avon Park, FL

Sources for this page

Verify at the official NPI Registry.