Organization Active NPI

Prime Care Managers, LLC

  • Family Medicine Physician
  • Longview, TX
National Provider Identifier
1104541390
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PRIME CARE MANAGERS, LLC
Practice address
4002 Technology Ctr
Longview, TX 75605-2697
Phone
(903) 247-0525
Fax
(903) 230-2709
NPI assigned
Oct 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Authorized official

Name
Miss Jeanette Schaublin, LVN
Title
Aco Coordinator
Phone
(903) 247-0525

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

4002 Technology Ctr
Longview, TX 75605-2697

Mailing address

4002 Technology Ctr
Longview, TX 75605-2697
Phone (903) 247-0525

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742342400000",
    "number": "1104541390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 TECHNOLOGY CTR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052697",
            "telephone_number": "903-247-0525",
            "fax_number": "903-230-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 TECHNOLOGY CTR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052697",
            "telephone_number": "903-247-0525",
            "fax_number": "903-230-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME CARE MANAGERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-10",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A",
        "authorized_official_last_name": "SCHAUBLIN",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "ACO COORDINATOR",
        "authorized_official_telephone_number": "903-247-0525",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LVN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; 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.