Primecare Family Medicine LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME47294 Issued in FL

Legal business name

PRIMECARE FAMILY MEDICINE LLC

Practice address

1890 Lpga Blvd
Suite 130
Daytona Beach, FL 32117-7130

Phone

(386) 274-2212

Fax

(386) 274-1508

NPI assigned

Jul 21, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Johnsie Carol Grigg, M.D.

Title

President

Phone

(386) 274-2212

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248134400000",
    "number": "1184854465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 LPGA BLVD",
            "address_2": "SUITE 130",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177130",
            "telephone_number": "386-274-2212",
            "fax_number": "386-274-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 LPGA BLVD",
            "address_2": "SUITE 130",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177130",
            "telephone_number": "386-274-2212",
            "fax_number": "386-274-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECARE FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-21",
        "last_updated": "2009-07-21",
        "status": "A",
        "authorized_official_last_name": "GRIGG",
        "authorized_official_first_name": "JOHNSIE",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-274-2212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME47294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primecare at Twin Lakes LLC
• Fay L Prince, RN
• Leeanne Pringle, MS, CCC-SLP
• Professional Radiology Associates PA
• Professional Surgical Assistants
• Progressive Medical Community

• Family Medicine Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; 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.