| Osteopathic Heritage, P.a. | |
|
959 W Jefferson St Brooksville FL 34601-2427 | |
| (352) 799-7000 | |
| (352) 799-7077 |
| Full Name | Osteopathic Heritage, P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 959 W Jefferson St, Brooksville, Florida |
| Authorized Official Name and Position | Jeffrey S. Grove (OWNER/PRESIDENT) |
| Authorized Official Contact | 3526666950 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Osteopathic Heritage, P.a. 959 W Jefferson St Brooksville FL 34601-2427 Ph: (352) 799-7000 | Osteopathic Heritage, P.a. 959 W Jefferson St Brooksville FL 34601-2427 Ph: (352) 799-7000 |
| NPI Number | 1316196744 |
|---|---|
| Provider Enumeration Date | 09/10/2008 |
| Last Update Date | 03/09/2018 |
| Medicare PECOS PAC ID | 6406907278 |
|---|---|
| Medicare Enrollment ID | O20090708000219 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316196744 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS6098 (Florida) | Primary |
| Provider Name | Suzanne E Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043262975 PECOS PAC ID: 6800886755 Enrollment ID: I20040513001127 |
| Provider Name | Jeffrey S Grove |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154313252 PECOS PAC ID: 9931152469 Enrollment ID: I20050225000185 |
| Provider Name | Nicole H Bixler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053381913 PECOS PAC ID: 7214919802 Enrollment ID: I20071005000503 |
| Provider Name | Brian J Bixler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326038613 PECOS PAC ID: 8628153574 Enrollment ID: I20080317000491 |
| Provider Name | Bryan M Stafford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194025510 PECOS PAC ID: 0749479459 Enrollment ID: I20110112000171 |
| Provider Name | Sisto Serafini |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366674046 PECOS PAC ID: 1254594252 Enrollment ID: I20120530000616 |
| Provider Name | Kera Marie Connolly |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1205149937 PECOS PAC ID: 3678714193 Enrollment ID: I20130725000942 |
| Provider Name | Matthew D Bowser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356654198 PECOS PAC ID: 5991947848 Enrollment ID: I20130806000662 |
| Provider Name | Audrey M Bellant |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972866010 PECOS PAC ID: 4385950773 Enrollment ID: I20150831001952 |
| Provider Name | Joshua D Lehman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265875074 PECOS PAC ID: 4688982994 Enrollment ID: I20151007000963 |
| Provider Name | Myrna E Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124476221 PECOS PAC ID: 7214217678 Enrollment ID: I20161201001231 |
| Provider Name | Daniel Alan Pedersen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619327780 PECOS PAC ID: 5799106456 Enrollment ID: I20200604001329 |
| Provider Name | Lauren Ortiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114658770 PECOS PAC ID: 7810369956 Enrollment ID: I20230217001707 |
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