SOUTHEAST VOLUSIA HEALTHCARE CORPORATION (NPI# 1710346093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710346093 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST VOLUSIA HEALTHCARE CORPORATION |
| Other Organization Name | ADVENTHEALTH MEDICAL GROUP |
| Practice Address |
600 Palmetto St New Smyrna Beach FL 32168-7327 |
| Mailing Address |
Po Box 864623 Orlando FL 32886-4623 |
| Practice Telephone | 3864245000 |
| Mailing Telephone | 3866714519 |
| Mailing Fax Number | 3866729904 |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2019-08-05 |
| Authorized Official Name | MARK RATHBUN (CFO) |
| Authorized Official Telephone | 3864245000 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHEAST VOLUSIA HEALTHCARE CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| AdventHealth Medical Group | Doing Business As Name - Organization |
| Florida Hospital New Smyrna | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871977942 | Southeast Volusia Healthcare Corporation | General Acute Care Hospital | 401 Palmetto St, New Smyrna Beach, FL 32168-7322 | 2015-07-17 |
| Street Address |
600 PALMETTO ST |
| City | NEW SMYRNA BEACH |
| State | FL |
| Zip Code | 32168-7327 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306830617 | Kimberly Lavita Clayton | Surgery | 600 Palmetto St, New Smyrna Beach, FL 32168-7327 | 2005-09-01 |
| 1033726286 | Ashley Nicole Pantuso | Nurse Practitioner | 600 Palmetto St, New Smyrna Beach, FL 32168-7327 | 2020-09-30 |
| 1316593114 | Aryan Modasi | Surgery | 600 Palmetto St, New Smyrna Beach, FL 32168-7327 | 2019-08-16 |
| 1336171917 | Frank W Toub | Specialist | 600 Palmetto St, New Smyrna Beach, FL 32168-7327 | 2006-07-06 |
| 1851368377 | Gregory G White | Specialist | 600 Palmetto St, New Smyrna Beach, FL 32168-7327 | 2006-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114546504 | Karen Lynn Gray | Occupational Therapist | 125 Memorial Medical Parkway, New Smyrna Beach, FL 32168 | 2020-04-15 |
| 1619500154 | Janelle Wadman | Physical Therapist | 1994 Sr-44, New Smyrna Beach, FL 32168 | 2020-02-12 |
| 1184262354 | Jessica Magers, LLC | Clinic/Center | 136 Julie St., New Smyrna Beach, FL 32168 | 2019-12-18 |
| 1760027171 | Jessica Lyn Magers | Counselor | 136 Julia Street, Unit 100, New Smyrna Beach, FL 32168 | 2019-11-08 |
| 1326453747 | Prc Associates, LLC | Anesthesiology | 501 S. Orange St., New Smyrna Beach, FL 32168 | 2014-06-24 |
| 1265842272 | David Farmer | Chiropractor | 532 Canal Street, New Smyrna Beach, FL 32168 | 2014-04-29 |
| 1184059750 | Fairgreen Assisted Living Inc. | Assisted Living Facility | 1150 Wayne Ave., New Smyrna Beach, FL 32168 | 2013-09-13 |
| 1427393982 | Jami L Peace | Hearing Instrument Specialist | 111 N Orange St, New Smyrna Beach, FL 32168 | 2012-12-10 |
| 1154608149 | Roberta Bornemann | Specialist | 519 Mill Run Drive, New Smyrna, FL 32168 | 2011-11-04 |
| 1023314358 | Scott Asman | Hearing Instrument Specialist | 1958 State Road 44, New Smyrna Beach, FL 32168 | 2011-02-03 |
| Find all providers in zip 32168 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154551653 | William Rengifo Cam | Internal Medicine | 501 Live Oak St Ste B, New Smyrna Beach, FL 32168-7300 | 2009-07-17 |
| 1144417387 | Russell E. Perry, M.d., P.a. | Internal Medicine | 406 Palmetto St Ste A, New Smyrna Beach, FL 32168-7323 | 2007-10-02 |
| 1760675599 | Theresa N Huyen | Internal Medicine | 914 N Dixie Fwy, New Smyrna Beach, FL 32168-6220 | 2007-08-24 |
| 1386731594 | Thomas W. Ownby Jr. M.d. P.a. | Internal Medicine | 510 Palmetto St, New Smyrna Beach, FL 32168-7325 | 2006-10-07 |
| 1194839977 | Gregory James Mercurio | Internal Medicine | 223 N Causeway, New Smyrna Beach, FL 32169-5239 | 2006-08-18 |
| 1467480301 | Charles William Schildecker | Internal Medicine | 401 Downing St, New Smyrna Beach, FL 32168-7109 | 2006-06-29 |
| 1457313421 | George Fredrick Herdel Jr. | Internal Medicine | 845 State Road 44, New Smyrna Beach, FL 32168-7271 | 2006-04-05 |
| 1841684735 | Laeeq Ahmed Butt | Internal Medicine | 401 Palmetto St, New Smyrna Beach, FL 32168-7322 | 2015-03-27 |
| 1942632260 | Staci Appleton, Mdpa | Internal Medicine | 161 N Causeway, Suite C, New Smyrna Beach, FL 32169-5303 | 2013-08-09 |
| 1053508283 | Greg J. Mercurio, Md, Pa | Internal Medicine | 1720 State Road 44, New Smyrna Beach, FL 32168-8339 | 2007-10-02 |
| Find all providers in NEW SMYRNA BEACH | ||||
| City | NEW SMYRNA BEACH |
| Zip Code | 32168 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.