Origins Family Medical & Weight Loss Clinic Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

ORIGINS FAMILY MEDICAL & WEIGHT LOSS CLINIC INC

Practice address

206 S Marion Ave
Lake City, FL 32025-7058

Phone

(386) 755-5014

Fax

(386) 755-3093

NPI assigned

Aug 20, 2013

Last updated

Sep 12, 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

Mr. Duane E. Thomas, ESQ.

Title

President/Director

Phone

(386) 755-5014

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 4

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.

• Girish - Bhaskar, MD

  • Pulmonary Disease Physician
  • Lake City, FL
  • NPI 1477599751
  Medicare reassignment NPD
• Osayande Stephen Izeiyamu, MD

  • General Practice Physician
  • Lake City, FL
  • NPI 1255698619
  Medicare reassignment NPD
• Todd A. Perla, M.D.

  • Family Medicine Physician
  • Lake City, FL
  • NPI 1235146408
  Medicare reassignment NPD
• Rodney Lee Scyphers, ARNP-C, MSN

  • Family Nurse Practitioner
  • Branford, FL
  • NPI 1942254651
  Medicare reassignment NPD

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1962835306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 SW WALL TER",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255086",
            "telephone_number": "386-719-9227",
            "fax_number": "386-719-9488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 S MARION AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320257058",
            "telephone_number": "386-755-5014",
            "fax_number": "386-755-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORIGINS FAMILY MEDICAL & WEIGHT LOSS CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-20",
        "last_updated": "2013-09-12",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "DUANE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT/DIRECTOR",
        "authorized_official_telephone_number": "386-755-5014",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Olson
• Adetokunbo Oluwasanjo, MD
• Omni Home Health Hernando, LLC (SunCrest OMNI)
• Omni Home Health- Hernando, LLC (SunCrest OMNI)
• Eric Ordinario, D.O.
• Michael Ortiz
• Miguel Angel Ortiz
• Osprey of North Florida, Inc. (Baya Pointe Nursing & Rehabilitation Center)
• Donna Frances Osteen
• Taylor N Ostendorf

• General Practice Physician in Lake City, FL
• Providers in Lake City, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.