NPIMap

Organization Active NPI

Atlantic Cardiovascular & Thoracic Surgeons, LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Ormond Beach, FL
National Provider Identifier
1962831883
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
ME36700 Issued in FL
Legal business name
ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC
Practice address
1240 W Granada Blvd FL 2
Ormond Beach, FL 32174-5915
Phone
(862) 366-8543
Fax
(862) 632-9963
NPI assigned
Nov 1, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Authorized official

Name
William Hampton Johnson III, M.D.
Title
Operating Manager
Phone
(386) 672-9503

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X ME36700 FL
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X ME58979 FL
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X ME36700 FL Primary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X ME58979 FL

Addresses

Primary practice location

1240 W Granada Blvd FL 2
Ormond Beach, FL 32174-5915

Mailing address

1240 W Granada Blvd FL 2
Ormond Beach, FL 32174-5915
Phone (386) 236-6854

Other names 1

  • Coastal Cardiovascular & Thoracic Associates, P.A. Former legal business name

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1240 W Granada Blvd
Ormond Beach, FL 32174
Phone (386) 898-0220

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1383264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1962831883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 W GRANADA BLVD FL 2",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745915",
            "telephone_number": "386-236-6854",
            "fax_number": "386-263-2996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 W GRANADA BLVD FL 2",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745915",
            "telephone_number": "862-366-8543",
            "fax_number": "862-632-9963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC CARDIOVASCULAR & THORACIC SURGEONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-01",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "HAMPTON",
        "authorized_official_title_or_position": "OPERATING MANAGER",
        "authorized_official_telephone_number": "386-672-9503",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME36700",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "FL",
            "license": "ME58979",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME36700",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME58979",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Cardiovascular & Thoracic Associates, P.A.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.