PRIME HEALTH MEDICAL CLINIC, PA (NPI# 1063781094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063781094 |
| Entity Type | Organization |
| Organization Name | PRIME HEALTH MEDICAL CLINIC, PA |
| Practice Address |
6801 South Blvd Suite E Charlotte NC 28217-4458 |
| Practice Telephone | 7049405599 |
| Practice Fax Number | 7049405589 |
| Mailing Telephone | 7049405599 |
| Mailing Fax Number | 7049405589 |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2016-10-13 |
| Authorized Official Name | DR. SYLVESTER I OGBATA (OWNER) |
| Authorized Official Telephone | 7049405599 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RH0002X |
Internal Medicine Specialization: Hospice and Palliative Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| Street Address |
6801 SOUTH BLVD SUITE E |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28217-4458 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437342151 | Stefan A Ploszak | Dentist | 6801 South Blvd, Ste F, Charlotte, NC 28217-4458 | 2007-08-27 |
| 1851826499 | Carolinas Nephrology and Hypertension Associates, Pa | Internal Medicine | 6801 South Blvd, Charlotte, NC 28217-4458 | 2017-04-20 |
| 1952609687 | Qc Kidz Pediatrics Pllc | Clinic/Center | 6801 South Blvd, Charlotte, NC 28217-4458 | 2011-03-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962017798 | Kelby Rae Hurlocker | Specialist/Technologist | 500 Center Park Dr, Charlotte, NC 28217 | 2020-09-09 |
| 1356967749 | Optum Pharmacy 701, LLC | Pharmacy | 4015 Shopton Rd, Suite 600, Charlotte, NC 28217 | 2020-06-22 |
| 1598302937 | Brigit Boyce | Occupational Therapist | 8848 Red Oak Blvd, Ste Aa, Charlotte, NC 28217 | 2019-12-04 |
| 1275016933 | Zarah Pulfrey | Physician Assistant | Womack Medical Center, 2817 Riley Road, Fort Bragg, NC 28217 | 2018-09-10 |
| 1972085918 | Dynamic Health Medical Group Pllc | Pain Medicine | 4705 South Blvd, Charlotte, NC 28217 | 2018-09-06 |
| 1184102048 | Charday Caple | Counselor | 735 Echodale Dr, Charlotte, NC 28217 | 2018-08-02 |
| 1326532250 | Dupont Livery LLC | Non-emergency Medical Transport (VAN) | 4200 S Tryon St, Charlotte, NC 28217 | 2018-06-14 |
| 1891215232 | Lakesha Shamise Welch | Counselor | 5709 South Hampton R., Charlotte, NC 28217 | 2017-06-27 |
| 1245768282 | Allison Harris Lafone | Counselor | 515 Clanton Road, Charlotte, NC 28217 | 2017-06-02 |
| 1619416906 | Charlie Randolph Taylor Jr. | Counselor | 517 Clanton Road, Charlotte, NC 28217 | 2017-02-20 |
| Find all providers in zip 28217 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972860310 | Southcross Family Medicine Pllc | Internal Medicine | 1341 E Morehead Street, 101, Charlotte, NC 28204 | 2012-04-23 |
| 1275869364 | White Magnolia Services Inc | Internal Medicine | 9009 Albemarle Rd, Suite 101-385, Charlotte, NC 28227-2600 | 2009-10-23 |
| 1639229206 | Thomas Richard Smarz Jr. | Internal Medicine | 7903 Providence Rd Ste 110, Charlotte, NC 28277-8300 | 2007-01-12 |
| 1144247750 | Adit S Mahale | Internal Medicine | 2711 Randolph Rd Ste 400, Charlotte, NC 28207-2027 | 2006-07-17 |
| 1851826499 | Carolinas Nephrology and Hypertension Associates, Pa | Internal Medicine | 6801 South Blvd, Charlotte, NC 28217-4458 | 2017-04-20 |
| 1215191143 | Matthew Ryan Elliott | Internal Medicine | 2711 Randolph Rd, Bldg 400, Charlotte, NC 28207-2034 | 2008-07-10 |
| 1649386665 | Peale Chuang | Internal Medicine | 2711 Randolph Rd, Bldg 400, Charlotte, NC 28207-2034 | 2006-08-22 |
| 1710927421 | Donald P. Berling | Internal Medicine | 2711 Randolph Rd, Bldg 400, Charlotte, NC 28207-2027 | 2006-06-08 |
| 1588610802 | Benjamin E. Hippen | Internal Medicine | 2711 Randolph Rd, Bldg 400, Charlotte, NC 28207-2027 | 2006-05-26 |
| 1477509719 | Kent H. Raymond | Internal Medicine | 2711 Randolph Rd, Bldg 400, Charlotte, NC 28207-2027 | 2006-05-26 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.