NPIMap

Organization Active NPI

Primary Care Specialists, LLC

  • Family Medicine Physician
  • Oviedo, FL
National Provider Identifier
1114010824
Registry record updated Jun 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PRIMARY CARE SPECIALISTS, LLC
Practice address
2572 W State Road 426
Suite 1040
Oviedo, FL 32765-8389
Phone
(407) 366-9800
Fax
(407) 366-9283
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2011

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

Authorized official

Name
Gerald J Kivett, MD
Title
Partner
Phone
(407) 275-9014

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2572 W State Road 426
Suite 1040
Oviedo, FL 32765-8389

Mailing address

2572 West St Rd 426 Suite 1040
Oviedo, FL 32765
Phone (407) 366-9800

Other identifiers 3

IdentifierTypeStateIssuer
24506OtherFLBCBS
207Q00000XOtherFLFAMILY PRACTICE
363L00000XOtherFLNURSE PRACTITIONER

National Provider Directory

National Provider Directory
Tax ID family
Primary Care Specialist5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

2572 W State Road 426
Ste 1040
Oviedo, FL 32765
Phone (407) 366-9800

Practitioners & affiliated clinicians

Practitioners 1

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308096000000",
    "number": "1114010824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2572 WEST ST RD 426 SUITE 1040",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "32765",
            "telephone_number": "407-366-9800",
            "fax_number": "407-366-9283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2572 W STATE ROAD 426",
            "address_2": "SUITE 1040",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327658389",
            "telephone_number": "407-366-9800",
            "fax_number": "407-366-9283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2011-06-15",
        "status": "A",
        "authorized_official_last_name": "KIVETT",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "407-275-9014",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "24506",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY PRACTICE",
            "identifier": "207Q00000X",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER",
            "identifier": "363L00000X",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; 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.