Primecare Family Practice LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

21082 Issued in SC

Legal business name

PRIMECARE FAMILY PRACTICE LLC

Practice address

145 St James Ave
Goose Creek, SC 29445-2923

Phone

(843) 863-0777

Fax

(843) 824-6119

NPI assigned

Oct 17, 2007

Last updated

Apr 14, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adebola Edward Rojugbokan, MDNPI 1922015692

Title

Physician

Phone

(843) 863-0777

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Adebola E Rojugbokan, M.D.

  • Family Medicine Physician
  • Goose Creek, SC
  • NPI 1922015692
  NPD Authorized official
• Lewis Nchoga Nyantika, CERTIFIED FNP

  • Family Nurse Practitioner
  • Arlington, TX
  • NPI 1205453958
  NPD (past)
• Maryline Ongangi, FNP

  • Family Nurse Practitioner
  • Arlington, TX
  • NPI 1215217351
  NPD (past)

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208131200000",
    "number": "1073702957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294450160",
            "telephone_number": "843-863-0777",
            "fax_number": "843-824-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 ST JAMES AVE",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294452923",
            "telephone_number": "843-863-0777",
            "fax_number": "843-824-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECARE FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2008-04-14",
        "status": "A",
        "authorized_official_last_name": "ROJUGBOKAN",
        "authorized_official_first_name": "ADEBOLA",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "843-863-0777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "21082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3958",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• PPCP Specialty Physicians , LLC
• PPCP Specialty Physicians , LLC
• Nathaniel Kevin Prater, PT, DPT
• Kathleen O Price, APRN
• William David Price, MD
• Ashlee Jeane' Prince
• Queen-Ella Pringle, LPC-A
• Joann D Privette, IBCLC
• Proactive Therapy of South Carolina Inc (Select Physical Therapy)
• Stephen Douglas Pyles, LICENSED OPTICIAN

• Family Medicine Physician in Goose Creek, SC
• Providers in Goose Creek, SC by specialty
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.