PRIMARY CARE MEDICAL GROUP, LLC (NPI# 1982114385) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982114385 |
| Entity Type | Organization |
| Organization Name | PRIMARY CARE MEDICAL GROUP, LLC |
| Practice Address |
36600 N. Pima Road Ste 307 Carefree AZ 85377 |
| Mailing Address |
11801 N Tatum Blvd Ste 145 Phoenix AZ 85028-1613 |
| Practice Telephone | 4802805085 |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2017-10-11 |
| Authorized Official Name | KENNETH KEARNS (OWNER) |
| Authorized Official Telephone | 4802805085 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 33789 | AZ | Allopathic & Osteopathic Physicians |
| Street Address |
36600 N. PIMA ROAD STE 307 |
| City | CAREFREE |
| State | AZ |
| Zip Code | 85377 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417579913 | Patricia Lillian Miller | Counselor | 36809 N Dream St, Carefree, AZ 85377 | 2020-05-07 |
| 1023658127 | Carefree Manor Assisted Living LLC | Residential Treatment Facility, Physical Disabilities | 7886 E Breathless Dr, Carefree, AZ 85377 | 2020-01-07 |
| 1457997744 | Dream Street Care LLC | Custodial Care Facility | 37412 N Dream Street, Carefree, AZ 85377 | 2019-11-21 |
| 1083189112 | Naomi Nicole Jimenez | Nurse Practitioner | 36889 N. Tom Darlington Dr. A4, Carefree, AZ 85377 | 2018-10-04 |
| 1861917379 | Shauna Leigh Epperson | Physical Therapist | 36600 N Pima Rd #406, Carefree, AZ 85377 | 2017-08-04 |
| 1982139804 | Kaylee Paciora | Dietitian, Registered | 36800 N. Sidewinder Rd, A4, Carefree, AZ 85377 | 2017-04-28 |
| 1508308909 | Colleen Payne | Nurse Practitioner | 36800 N. Sidewinder Road, Ste A4, Carefree, AZ 85377 | 2016-11-16 |
| 1598148223 | Kenneth Kearns | Obstetrics & Gynecology | 36600 N. Pima Rd, Carefree, AZ 85377 | 2015-06-30 |
| 1699178020 | Faiza Malik | Pharmacist | 5400 East Carefree Highway, Carefree, AZ 85377 | 2014-09-30 |
| 1477813871 | George Koukouves | Massage Therapist | 36800 N. Sidewinder, A-8, Carefree, AZ 85377 | 2012-05-21 |
| Find all providers in zip 85377 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417142829 | Thomas Wright Lutz | General Practice | 6443 E El Sendero, Carefree, AZ 85377-2521 | 2007-09-10 |
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| 1366080475 | Madison Taylor Phillips | General Practice | 15741 Bering St, Ehrenberg, AZ 85334-0010 | 2019-12-19 |
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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.