Provident Orthopedic and Sports Medicine Center

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

PROVIDENT ORTHOPEDIC AND SPORTS MEDICINE CENTER

Practice address

801 Marshall Farms Rd
Ocoee, FL 34761-3316

Phone

(407) 906-3621

Fax

(407) 614-3171

NPI assigned

Jun 11, 2016

Organization subpart

No

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

Authorized official

Name

Paul F Shuler, MDNPI 1316038565

Title

Manager

Phone

(920) 344-8665

Specialties & licenses 1

Addresses

Other names 1

• Provident Other name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul F Shuler, MD

  • Orthopaedic Surgery Physician
  • Ocoee, FL
  • NPI 1316038565
  Medicare reassignment Care Compare group NPD Authorized official
• Mary Michelle Cameron, PA-C

  • Physician Assistant
  • Ocoee, FL
  • NPI 1407987886
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1465603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726272000000",
    "number": "1952750713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 MARSHALL FARMS RD",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613316",
            "telephone_number": "407-906-3621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MARSHALL FARMS RD",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613316",
            "telephone_number": "407-906-3621",
            "fax_number": "407-614-3171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENT ORTHOPEDIC AND SPORTS MEDICINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-11",
        "last_updated": "2024-09-14",
        "certification_date": "2024-09-14",
        "status": "A",
        "authorized_official_last_name": "SHULER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "920-344-8665",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Provident",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Provident",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Orthopaedic Surgery Physician in Ocoee, FL
• Providers in Ocoee, FL by specialty
• Orthopaedic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2024; 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.