Freedom Health and Wellness of Lake City, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FREEDOM HEALTH AND WELLNESS OF LAKE CITY, LLC

Practice address

263 SW Professional GLN
Lake City, FL 32025-1105

Phone

(386) 623-0850

NPI assigned

Nov 21, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Misty Herndon

Title

Owner

Phone

(386) 623-0850

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520467200000",
    "number": "1396259735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 SW PROFESSIONAL GLN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251105",
            "telephone_number": "386-623-0850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 SW PROFESSIONAL GLN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251105",
            "telephone_number": "386-623-0850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM HEALTH AND WELLNESS OF LAKE CITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-21",
        "last_updated": "2018-03-08",
        "status": "A",
        "authorized_official_last_name": "HERNDON",
        "authorized_official_first_name": "MISTY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-623-0850",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyesha L Foster
• Robert E Fox, PA-C
• Juana Franco
• Kurt Frazier
• Natasha Lynn Fredericks Klein, LCSW
• Alice Elizabeth Freeman-Morrison
• Alexis S Freeman
• Randa French, APRN,FNP-C
• Brian Michael Frett, PHYSICAL THERAPIST
• Patrick Brock Friar

• Family Medicine Physician in Lake City, FL
• Providers in Lake City, 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 Mar 8, 2018; 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.