Ellenton Family Practice Direct PLLC
NPI 1124471503ActiveOrganization· Family Medicine· Ellenton, FL
Family Medicine in Ellenton, Florida, registered in NPPES in July 2016. The authorized official on file is David Allan Hervig, PA-C, Office Manage And Partner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1124471503 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 20, 2016 |
| Last updated in NPPES | Mar 7, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | PA9102767 | FL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (FL) |
|---|
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