Organization Active NPI

Primary Care Solutions Inc

  • Community/Behavioral Health Agency
  • Charlotte, NC
National Provider Identifier
1053535369
Registry record updated Mar 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PRIMARY CARE SOLUTIONS INC
Practice address
5601 Executive Center Dr Ste 200
Charlotte, NC 28212-8841
Phone
(704) 537-1022
Fax
(704) 569-0822
NPI assigned
Apr 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Marisil Burgos
Title
Qa Qi Director
Phone
(704) 537-1022

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Case Management Agency 251B00000X 8301186 NC
Community/Behavioral Health Agency 251S00000X Primary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X NC
Non-emergency Medical Transport (VAN) 343900000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

5601 Executive Center Dr Ste 200
Charlotte, NC 28212-8841

Mailing address

5601 Executive Center Dr Ste 200
Charlotte, NC 28212-8841
Phone (704) 537-1022

Other practice location 1

6807 Idlewild Brook Ln
Charlotte, NC 28212-5858
Phone (704) 537-1022

Other practice location 2

5501 Executive Center Dr
Suite 108
Charlotte, NC 28212-8866
Phone (704) 537-1022

Other practice location 3

2744 Fairstone Ave
Charlotte, NC 28269-5412
Phone (704) 537-1022

Other practice location 4

438 E Long Ave Ste 1
Gastonia, NC 28054-3500
Phone (704) 854-9595

Other identifiers 2

IdentifierTypeStateIssuer
8301186BMedicaidNC
8301186GMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161209001906 NC Part B Supplier - Clinic/Group Practice 5890075741 Receives reassigned benefits from 2 practitioners
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory
Tax ID family
Primary Care Solutions Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648080000000",
    "number": "1053535369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 EXECUTIVE CENTER DR STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128841",
            "telephone_number": "704-537-1022",
            "fax_number": "704-569-0822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 EXECUTIVE CENTER DR STE 200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128841",
            "telephone_number": "704-537-1022",
            "fax_number": "704-569-0822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6807 Idlewild Brook Ln",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282125858",
            "country_code": "US",
            "telephone_number": "704-537-1022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5501 Executive Center Dr",
            "address_2": "Suite 108",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282128866",
            "country_code": "US",
            "telephone_number": "704-537-1022",
            "fax_number": "704-569-0822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2744 Fairstone Ave",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282695412",
            "country_code": "US",
            "telephone_number": "704-537-1022",
            "fax_number": "704-569-0822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "438 E Long Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280543500",
            "country_code": "US",
            "telephone_number": "704-854-9595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIMARY CARE SOLUTIONS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A",
        "authorized_official_last_name": "BURGOS",
        "authorized_official_first_name": "MARISIL",
        "authorized_official_title_or_position": "QA QI DIRECTOR",
        "authorized_official_telephone_number": "704-537-1022"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": "8301186",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301186B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301186G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.