Prime Care of Georgia LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PRIME CARE OF GEORGIA LLC

Practice address

1000 Towne Center Blvd Ste 604
Pooler, GA 31322-4070

Phone

(912) 561-7001

Fax

(912) 561-7002

NPI assigned

May 17, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Shital G Patel, MDNPI 1639498181

Title

Provider

Phone

(912) 561-7001

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

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

• Shital Patel, M.D.

  • Internal Medicine Physician
  • Pooler, GA
  • NPI 1639498181
  Medicare reassignment NPD Authorized official
• Neha Prabhakar Kharod, MD

  • Allergy & Immunology (Internal Medicine) Physician
  • Pooler, GA
  • NPI 1851520019
  NPD (past)

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1114591096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 TOWNE CENTER BLVD STE 604",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224070",
            "telephone_number": "912-561-7001",
            "fax_number": "912-561-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 TOWNE CENTER BLVD STE 604",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224070",
            "telephone_number": "912-561-7001",
            "fax_number": "912-561-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME CARE OF GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-17",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "SHITAL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "912-561-7001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Micah Preston
• Brittany Price
• Shannon Priest, PHARMD
• Emory Delaine Priester
• Prime Care of Georgia II LLC
• Publix Super Markets Inc
• Publix Super Markets, Inc
• Pure Focus
• Braden S Putich, DDS
• Samantha Suzanne Quach, LCSW

• Internal Medicine Physician in Pooler, GA
• Providers in Pooler, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.