Prime Medical Group, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PRIME MEDICAL GROUP, PC

Practice address

6005 Park Ave
Suite 433B
Memphis, TN 38119-5202

Phone

(901) 255-1140

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Taslim A Khattak, MDNPI 1679540298

Title

President

Phone

(901) 255-1140

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3353/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.

• Taslim A Khattak, M.D.

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1679540298
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556755200000",
    "number": "1073624144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 PARK AVE STE 433B",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195211",
            "telephone_number": "901-255-1140",
            "fax_number": "901-255-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 PARK AVE",
            "address_2": "SUITE 433B",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195202",
            "telephone_number": "901-255-1140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME MEDICAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-05-02",
        "status": "A",
        "authorized_official_last_name": "KHATTAK",
        "authorized_official_first_name": "TASLIM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-255-1140",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3724095",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09016225",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Primacy Medical Services P.C.
• Primary Care Group LLC
• Primary Care Link LLC
• Primary Care Specialists
• Primary Healthcare Management LLC
• Primus Medical Group PC
• Jacqueline Olivia Prince Griffin
• Patricia Elizabeth Prince-Griffin, M.S.
• Amy Nicole Prince, RN-BSN
• Darrell Nathanael Prince, ADIV

• Internal Medicine Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; 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.