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

Organization subpart

No

Name

Mr. Duane E. Thomas, ESQ.

Title

President/Director

Phone

(386) 755-5014

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

• Girish - Bhaskar, MD

  • Pulmonary Disease Physician
  • Lake City, FL
  • NPI 1477599751

  FL

  Medicare reassignment NPD
• Osayande Stephen Izeiyamu, MD

  • General Practice Physician
  • Lake City, FL
  • NPI 1255698619

  FL, General Practice

  Medicare reassignment NPD
• Todd A. Perla, M.D.

  • Family Medicine Physician
  • Lake City, FL
  • NPI 1235146408

  FL

  Medicare reassignment NPD
• Rodney Lee Scyphers, ARNP-C, MSN

  • Family Nurse Practitioner
  • Branford, FL
  • NPI 1942254651

  FL

  Medicare reassignment NPD

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 12, 2013.

{
    "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Olson
• Adetokunbo Oluwasanjo, MD
• Omni Home Health Hernando, LLC
• Omni Home Health- Hernando, LLC
• Eric Ordinario, D.O.
• Michael Ortiz
• Miguel Angel Ortiz
• Osprey of North Florida, Inc.
• Donna Frances Osteen
• Taylor N Ostendorf

• All providers in Lake City, FL
• 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.