Heritage Family Medicine, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME105126 Issued in FL

Legal business name

HERITAGE FAMILY MEDICINE, LLC

Practice address

101 E Wisconsin Ave
Bonifay, FL 32425-1809

Phone

(850) 547-2209

Fax

(850) 547-4521

NPI assigned

Apr 24, 2013

Last updated

Apr 24, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Patrick Hawkins, M.D.

Title

Physician

Phone

(850) 547-2209

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 1

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.

• Leisa H Bailey, M.D.

  • Family Medicine Physician
  • Bonifay, FL
  • NPI 1851314330
  NPD (past)

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366761600000",
    "number": "1124462981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E WISCONSIN AVE",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "324251809",
            "telephone_number": "850-547-2209",
            "fax_number": "850-547-4521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E WISCONSIN AVE",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "324251809",
            "telephone_number": "850-547-2209",
            "fax_number": "850-547-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-24",
        "last_updated": "2013-04-24",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "850-547-2209",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME105126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372395000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003587000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "18651",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "FH128Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oliver Martin Hasek Jr., MD
• Hawkins Family Medicine LLC
• Patrick L Hawkins, M.D.
• Healing Palms Oxygen Instute, Inc.
• Herbert E Brooks MD PA
• Kelly Lynn Hill, RN
• Holmes Council on Aging
• Holmes County Hospital Corp (Doctors Memorial Hospital)
• Holmes County Hospital Corp (Bonifay Rural Health Clinic)
• Holmes County Hospital Corporation

• Family Medicine Physician in Bonifay, FL
• Providers in Bonifay, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; 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.