PRIME CARE MEDICAL CENTER SC (NPI# 1427228642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427228642 |
| Entity Type | Organization |
| Organization Name | PRIME CARE MEDICAL CENTER SC |
| Practice Address |
99 Boulder Hill Pass Montgomery IL 60538-1911 |
| Practice Telephone | 6308972848 |
| Practice Fax Number | 6308974498 |
| Mailing Telephone | 6308972848 |
| Mailing Fax Number | 6308974498 |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2008-03-04 |
| Authorized Official Name | MR. NICHOLAS GEORGE TZANETAKOS (PRES OWNER) |
| Authorized Official Telephone | 6308972848 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | IL | Allopathic & Osteopathic Physicians | |
| N | 207Q00000X | Family Medicine | IL | Allopathic & Osteopathic Physicians | |
| N | 207R00000X | Internal Medicine | IL | Allopathic & Osteopathic Physicians | |
| Y | 207Q00000X | Family Medicine | IL | Allopathic & Osteopathic Physicians |
| Street Address |
99 BOULDER HILL PASS |
| City | MONTGOMERY |
| State | IL |
| Zip Code | 60538-1911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720126535 | Nicholas George Tzanetakos | Family Medicine | 99 Boulder Hill Pass, Montgomery, IL 60538 | 2007-02-02 |
| 1356522023 | Valley Imaging Vt, LLC | Radiology | 99 Boulder Hill Pass, Montgomery, IL 60538-1911 | 2007-11-21 |
| 1851428114 | Lisette Tzanetakos Solomon | Internal Medicine | 99 Boulder Hill Pass, Montgomery, IL 60538 | 2007-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447594296 | Kristina Nancy Hajek | Physician Assistant | 1851 Douglas Road, Montgomery, IL 60538 | 2012-11-17 |
| 1003025248 | Matthew Thomas Neu | Preventive Medicine | 325 Route 31, Caterpillar Inc, Medical Division, Montgomery, IL 60538 | 2007-05-22 |
| 1477761567 | West Suburban Dental Care, Ltd. | Dentist | 1901 Douglas Rd, Montgomery, IL 60538 | 2007-05-20 |
| 1093834079 | David D Leger | Chiropractor | 2100 Baseline Rd, Montgomery, IL 60538 | 2007-03-28 |
| 1790816650 | Tina Elizabeth Sunderland | Specialist/Technologist | 22 Ashlawn Ave, Montgomery, IL 60538 | 2007-03-09 |
| 1184638603 | Neil Stewart Schlupp | Chiropractor | 212 Webster Street, Montgomery, IL 60538 | 2006-07-28 |
| 1275570061 | Ridge Ambulance Service Inc | Ambulance | 1851 Aucutt Rd, Montgomery, IL 60538 | 2006-06-01 |
| 1487855839 | Linda Gioia Arrich | Dentist | 1901 Douglas Rd, Montgomery, IL 60538 | 2007-05-31 |
| 1750508339 | Michael Harry Kontos | Dentist | 20 Boulder Hill Pass, Montgomery, IL 60538 | 2007-04-18 |
| 1396954541 | William Robert Roggenkamp | Preventive Medicine | 325 Route 31, Montgomery, IL 60538-0348 | 2007-05-22 |
| Find all providers in zip 60538 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952919490 | Age Well Concierge Medicine | Family Medicine | 18441 Tx-105, Suite B, Montgomery, TX 77356 | 2020-07-21 |
| 1992313670 | Integrated Medical Care Pllc | Family Medicine | 10427 Twin Circles Dr, Montgomery, TX 77356-4704 | 2020-07-17 |
| 1750906921 | Doctors Making Home Visits 1st Inc | Family Medicine | 922 S Perry St, Montgomery, AL 36104-5022 | 2020-06-12 |
| 1508496688 | Montgomery General Hospital, Inc | Family Medicine | 401 6th Ave Ste 301, Montgomery, WV 25136-2116 | 2020-01-17 |
| 1427521962 | Health Services, Inc | Family Medicine | 2801 Willena Ave, Montgomery, AL 36107-1055 | 2019-01-08 |
| 1750869814 | Nina Yvette Massey | Family Medicine | Baptist South Uab Multi Specialty Clinic, 2119 E. South Blvd, Montgomery, AL 36116 | 2018-08-01 |
| 1871010223 | Micah Bosley Md, Pllc | Family Medicine | 102 Piping Rock Dr, Montgomery, TX 77356-5860 | 2017-08-26 |
| 1003267899 | Your Doctor's Office, PC | Family Medicine | 8630 Vaughn Rd, Montgomery, AL 36117-8852 | 2016-06-23 |
| 1194175513 | Miho Suga | Family Medicine | 1801 Pine St Ste 301, Montgomery, AL 36106-1154 | 2016-06-16 |
| 1265834618 | Sarah Elizabeth Connors | Family Medicine | 4150 Carmichael Rd Ste B, Montgomery, AL 36106-2933 | 2014-09-17 |
| Find all providers in MONTGOMERY | ||||
| City | MONTGOMERY |
| Zip Code | 60538 |
Please comment or provide details below to improve the information on PRIME CARE MEDICAL CENTER SC.
| 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.