Prime Health Medical Clinic, PA

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

PRIME HEALTH MEDICAL CLINIC, PA

Practice address

1400 Medford Dr
Charlotte, NC 28205-5624

Phone

(704) 940-5588

Fax

(704) 940-5589

NPI assigned

Dec 20, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Sylvester I Ogbata, MDNPI 1346209707

Title

Owner

Phone

(203) 545-9119

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/7062/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Sylvester Izuchukwu Ogbata, M.D.

  • Nephrology Physician
  • Charlotte, NC
  • NPI 1346209707
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1063781094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7619 BERRYFIELD CT",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281739817",
            "telephone_number": "203-545-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MEDFORD DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282055624",
            "telephone_number": "704-940-5588",
            "fax_number": "704-940-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTH MEDICAL CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-20",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A",
        "authorized_official_last_name": "OGBATA",
        "authorized_official_first_name": "SYLVESTER",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-545-9119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prime Care One, LLC
• Sydney Partin Primis, MD
• Ciara Cheyenne Primo
• Sonya Medlin Primo, PTA
• Primus Therapy Services, PLLC
• Makenzy Prince

• Nephrology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Nephrology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.