Primary Medical LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

71848 Issued in GA

Legal business name

PRIMARY MEDICAL LLC

Practice address

4390 Cedar Bridge Walk
Suwanee, GA 30024-1323

Phone

(469) 442-8584

NPI assigned

Jul 23, 2015

Organization subpart

No

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

Authorized official

Name

Ravi K PasupuletiNPI 1295134245

Title

Owener

Phone

(469) 442-8584

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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

• Ravi Kumar Pasupuleti, M.D

  • Family Medicine Physician
  • Norcross, GA
  • NPI 1295134245
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437609600000",
    "number": "1275918914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4390 CEDAR BRIDGE WALK",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241323",
            "telephone_number": "469-442-8584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4390 CEDAR BRIDGE WALK",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241323",
            "telephone_number": "469-442-8584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-23",
        "last_updated": "2015-07-23",
        "status": "A",
        "authorized_official_last_name": "PASUPULETI",
        "authorized_official_first_name": "RAVI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWENER",
        "authorized_official_telephone_number": "469-442-8584"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "71848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premise Health of Georgia Medical PC
• Dawn Michelle Preseau, RBT
• Areigna Marie Preston, OMT, LMT, BCTMB
• Pri X-Ray, L.L.C.
• Primacare Rehabilitation P.C.
• Prime Family Medicine and Wellness Center LLC
• Prime Veritas LLC
• Procore Med, LLC
• Prosper Perfromance & Physical Therapy
• Prosperity Pathways Foundation Inc

• Family Medicine Physician in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.