PRIMARY MEDICAL CARE GROUP (NPI# 1689737603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689737603 |
| Entity Type | Organization |
| Organization Name | PRIMARY MEDICAL CARE GROUP |
| Practice Address |
5322 Snapfinger Park Dr Decatur GA 30035-4040 |
| Mailing Address |
Po Box 1741 Decatur GA 30031-1741 |
| Practice Telephone | 4042899784 |
| Practice Fax Number | 4042899785 |
| Mailing Telephone | 4042899784 |
| Mailing Fax Number | 4042899785 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2014-09-04 |
| Authorized Official Name | MUSIBAU A IBRAHEEM (PHYSICIAN OWNER) |
| Authorized Official Telephone | 4042899784 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
052963 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
5322 SNAPFINGER PARK DR |
| City | DECATUR |
| State | GA |
| Zip Code | 30035-4040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649247834 | Musibau A Ibraheem | Family Medicine | 5322 Snapfinger Park Dr, Decatur, GA 30035-4040 | 2006-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972079978 | James L Vinson, Phd | Home Health Aide | 4050 Snapfinger Woods Drive, Suite 201, Decatur, GA 30035 | 2018-10-17 |
| 1417445206 | Kamla Gonzales | Nurse Practitioner | 5146 Miller Woods Trl, Decatur, GA 30035 | 2018-04-26 |
| 1578924924 | Alicia Marie Johnson Bryant | Social Worker | 5878 Covington Hwy, Decater, GA 30035 | 2016-03-14 |
| 1568865756 | Tracy Roberson | Counselor | 4150 Snapfinger Woods Drive, Decatur, GA 30035 | 2014-10-01 |
| 1972927861 | Tyrone D. Lane Enterprises, Incorporated | Psychologist | 5304 Panola Industrial Boulevard, Suite L, Decatur, GA 30035 | 2014-02-12 |
| 1013255355 | Mervin E Williams | Pharmacist | 2075 South Hairston, Decatur, GA 30035 | 2013-01-22 |
| 1205187572 | Mariana Simpson-walker | Speech-Language Pathologist | 4262 Clausell Ct Ste A, Decatur, GA 30035 | 2012-09-27 |
| 1053683854 | Jimiesh G Crane | Dentist | 5243 Snapfinger Woods Dr Ste 105, Decatur, GA 30035 | 2012-02-08 |
| 1568765824 | Salih Robinson | Health Educator | 2511 Lantrac Ct, Decatur, GA 30035 | 2010-12-08 |
| 1831428234 | Thomas Counseling | Counselor | 3781 Presidential Parkway, Suite 111c, Chamblee, GA 30035 | 2009-12-14 |
| Find all providers in zip 30035 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821617036 | Matthew Charles Revilla | Family Medicine | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-04-09 |
| 1629586946 | Ashley Ferguson | Family Medicine | 330 N Wyckles Rd, Decatur, IL 62522-1034 | 2018-01-22 |
| 1538586995 | Dekalb Gpo LLC | Family Medicine | 2801 N Decatur Rd, Suite 200, Decatur, GA 30033-5949 | 2014-03-24 |
| 1033498118 | Syed Zia Ullah | Family Medicine | 2536 Lawrenceville Hwy, Decatur, GA 30033-3227 | 2011-08-08 |
| 1457473795 | Healing Innovations, P.C. | Family Medicine | 5040 Snapfinger Woods Dr, Suite 201, Decatur, GA 30035-4020 | 2007-04-06 |
| 1376665463 | Family Care Centers Trust | Family Medicine | 1045 Sycamore Dr, Adminstration, Decatur, GA 30030-1645 | 2007-04-06 |
| 1477672640 | Family Care Centers Trust | Family Medicine | 1045 Sycamore Dr, Decatur, GA 30030-1645 | 2007-03-28 |
| 1942373089 | Song Yol Yu | Family Medicine | 319 W Delaware St, Decatur, MI 49045-1106 | 2006-11-16 |
| 1609880160 | Shainul K Bhatia | Family Medicine | 1045 Sycamore Dr, Decatur, GA 30030-1645 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306464250 | Leah Reed | Family Medicine | 2082 Cherokee Farms Cv, Buford, GA 30519-7004 | 2020-07-08 |
| 1083240766 | Carehere LLC | Family Medicine | 114 N Jackson St, Albany, GA 31701-2583 | 2020-03-13 |
| 1518590744 | Octavia Raquel Holloway-freeman | Family Medicine | 301 Denmark St, Statesboro, GA 30458-5208 | 2020-02-17 |
| 1891331575 | Jenna Barnes | Family Medicine | 1107 Memorial Dr Ste 300, Dalton, GA 30720-8664 | 2019-11-18 |
| 1023651205 | Carehere LLC | Family Medicine | 750 S Perry St Ste 200, Lawrenceville, GA 30046-4804 | 2019-10-21 |
| 1003385733 | James G Hamilton Jr Md LLC | Family Medicine | 4898 Highway 197, Mount Airy, GA 30563-2442 | 2018-11-26 |
| 1780161323 | Personal Wellness Inc. | Family Medicine | 625 Boxwood Ter, Johns Creek, GA 30005-7217 | 2018-07-26 |
| 1073005138 | Lake Oconee Wellness Associates LLC | Family Medicine | 1097 Lake Oconee Pkwy Ste 201, Eatonton, GA 31024-9510 | 2018-06-05 |
| 1376034983 | Lee Pennington Mcnichols | Family Medicine | 2300 Bethelview Rd Ste 110-332, Cumming, GA 30040-9475 | 2018-05-21 |
| 1972021301 | Docpecox, LLC | Family Medicine | 755 Mount Vernon Hwy Ne Ste 350, Atlanta, GA 30328-4291 | 2017-09-06 |
| Find all providers with the same taxonomy | ||||
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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.