DR. WILLIAM ANGELO PRIMOS JR. (NPI# 1528040458) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528040458 |
| Entity Type | Individual |
| Full Name | DR. WILLIAM ANGELO PRIMOS JR. |
| Credential | MD |
| Practice Address |
108 Prominence Ct Ste 200 Dawsonville GA 30534-6340 |
| Mailing Address |
Po Box 742616 Atlanta GA 30374-2616 |
| Practice Telephone | 7708486190 |
| Mailing Telephone | 7702198420 |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2020-10-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080S0010X |
Pediatrics Specialization: Sports Medicine |
42395 | GA | Allopathic & Osteopathic Physicians |
| N | 2080S0010X |
Pediatrics Specialization: Sports Medicine |
39336 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 813658737A | 05 | |
| SC | N39665 | 05 | |
| NC | 8969208 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5445 Meridian Marks Rd Ne Ste 250, Atlanta, GA 303424767 | 4042551933 | 4042567924 |
| Street Address |
108 PROMINENCE CT STE 200 |
| City | DAWSONVILLE |
| State | GA |
| Zip Code | 30534-6340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083610711 | Dawn Sosebee | Nurse Practitioner | 108 Prominence Ct Ste 200, Dawsonville, GA 30534-6340 | 2005-06-27 |
| 1821647215 | Katelyn Westbrook Goodwin | Nurse Practitioner | 108 Prominence Ct Ste 200, Dawsonville, GA 30534-6340 | 2019-09-09 |
| 1477038107 | Paige Reece Hood | Nurse Practitioner | 108 Prominence Ct Ste 200, Dawsonville, GA 30534 | 2018-09-28 |
| 1457702862 | Soo Jin Lee | Family Medicine | 108 Prominence Ct Ste 200, Dawsonville, GA 30534 | 2016-06-27 |
| 1699120964 | John Travis Nelson | Family Medicine | 108 Prominence Ct Ste 200, Dawsonville, GA 30534-6340 | 2016-04-25 |
| 1700264728 | Trey Gunter | Family Medicine | 108 Prominence Ct Ste 200, Dawsonville, GA 30534 | 2015-05-11 |
| 1164522330 | George Joseph Petro Jr. | Internal Medicine | 108 Prominence Ct Ste 200, Dawsonville, GA 30534-6340 | 2006-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780175331 | Sharon Redd | Occupational Therapist | 923 Riverbend Rd, Dawsonville, GA 30534 | 2018-05-18 |
| 1588103808 | Hearing Aid Solutions LLC | Hearing Instrument Specialist | 169 Hwy 9, Suite 100, Dawsonville, GA 30534 | 2017-02-20 |
| 1881140598 | Meagan Wilson | Registered Nurse | 6002 Ga 53, Suite 100, Dawsonville, GA 30534 | 2016-09-01 |
| 1265892293 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 6002 Hwy 52 East, Suite 110, Dawsonville, GA 30534 | 2016-03-03 |
| 1174961304 | Meredith Michelle Tatum Hulsey | Physician Assistant | 1080 Lumpkin Campground Road S, Suite 300, Dawsonville, GA 30534 | 2013-06-10 |
| 1932467115 | David Kenneth Woolsey | Chiropractor | 1100 Old Dawson Village Rd, Suite 010, Dawsonville, GA 30534 | 2012-04-25 |
| 1275836769 | Martha Leslie Baker | Counselor | 121 Old Dawson Village Rd E, Building 800, Unit 010, Dawsonville, GA 30534 | 2010-12-06 |
| 1982914073 | James Paul Whitcomb | Pharmacist | 751 Highway 53 East Fred's #1451, Dawsonville, GA 30534 | 2010-10-07 |
| 1801123302 | Sj&j Spine and Pain Group | Pain Medicine | 5959 Highway 53 W, Suite 100b, Dawsonville, GA 30534 | 2009-11-04 |
| 1215260617 | Durall Capital Holdings, LLC | Clinic/Center | 35 Lumpkin Campground Road N, Dawsonville, GA 30534 | 2009-09-16 |
| Find all providers in zip 30534 | ||||
| Taxonomy Code | 2080S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Sports Medicine |
| A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639781768 | Ally Nicole Herrington | Pediatrics | 1275 Stanley Rd Nw, Kennesaw, GA 30152-4359 | 2020-08-19 |
| 1962845099 | Armand Monsour Scurfield | Pediatrics | 175 White St Nw Ste 200, Marietta, GA 30060-7901 | 2013-04-08 |
| 1225457518 | Ashley Brouillette | Pediatrics | 5445 Meridian Marks Rd Ste 250, Atlanta, GA 30342 | 2014-04-15 |
| 1942527932 | Steven Perry Schulenborg | Pediatrics | 6 Executive Park Dr Ne, Suite 10, Atlanta, GA 30329-2221 | 2010-04-29 |
| 1386837896 | Jerry Stephen Kroll | Pediatrics | 5445 Meridian Marks Rd Ne, Suite 250, Atlanta, GA 30342-4763 | 2007-08-20 |
| 1023039807 | Jeffrey W. Webb | Pediatrics | 59 Executive Park S, Atlanta, GA 30329-2208 | 2006-07-21 |
| 1245278159 | Diane Z Weems | Pediatrics | 1395 Eisenhower Dr, Savannah, GA 31406-3901 | 2006-06-03 |
| City | DAWSONVILLE |
| Zip Code | 30534 |
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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.