NPIMap

Organization Active NPI

Primary Care Anywhere, PLLC

  • Family Nurse Practitioner
  • Beaumont, TX
National Provider Identifier
1245898808
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
PRIMARY CARE ANYWHERE, PLLC
Practice address
4347 Phelan
Suite 101
Beaumont, TX 77707
Phone
(409) 767-9285
NPI assigned
May 30, 2019
Last updated
May 30, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2019

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

Authorized official

Name
Garrett Benjamin Roy, FNP-CNPI 1407108715
Title
Owner
Phone
(409) 767-9285

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

4347 Phelan
Suite 101
Beaumont, TX 77707

Mailing address

4347 Phelan
Suite 101
Beaumont, TX 77707
Phone (409) 767-9285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190906000865 TX Part B Supplier - Clinic/Group Practice 3577892132 Receives reassigned benefits from 12 practitioners
Practice locations: Beaumont, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559174400000",
    "number": "1245898808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4347 PHELAN",
            "address_2": "SUITE 101",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77707",
            "telephone_number": "409-767-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4347 PHELAN",
            "address_2": "SUITE 101",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77707",
            "telephone_number": "409-767-9285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE ANYWHERE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "status": "A",
        "authorized_official_last_name": "ROY",
        "authorized_official_first_name": "GARRETT",
        "authorized_official_middle_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-767-9285",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.