Primecare Medical Center

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PRIMECARE MEDICAL CENTER

Practice address

86 Upper Riverdale Rd SW Ste 201
Riverdale, GA 30274-2614

Phone

(770) 907-4219

NPI assigned

Sep 5, 2017

Last updated

Jul 21, 2022By 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

Miss Bridgette HanniganNPI 1619417094

Title

Chief Executive Officer

Phone

(678) 755-5334

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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.

• Bridgette Hannigan, RCS

  • Sonography Specialist/Technologist Cardiovascular
  • Acworth, GA
  • NPI 1619417094
  Authorized official Same address or phone

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1164940672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 UPPER RIVERDALE RD SW STE 201",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742614",
            "telephone_number": "770-907-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 UPPER RIVERDALE RD SW STE 201",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742614",
            "telephone_number": "770-907-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECARE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-05",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HANNIGAN",
        "authorized_official_first_name": "BRIDGETTE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "678-755-5334",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mathilda Prevost
• Prime Healthcare Foundation - Southern Regional, LLC (Southern Regional Medical Center)
• Prime Healthcare Foundation - Southern Regional, LLC (Southern Regional Medical Center)
• Prime Healthcare Foundation - Southern Regional, LLC
• Prime RX Consultant Services Inc (Riverdale Pharmacy)
• Richard Prokesch, M.D.
• Promed Ambulance Service
• Padma Niharika Putrevu, MD
• QMG Healthcare & Group Home LLC
• Quality Personal Assistance

• Primary Care Clinic/Center in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.