NPIMap

Organization Active NPI

Center for Primary Care PC

  • Family Medicine Physician
  • Evans, GA
National Provider Identifier
1316973472
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CENTER FOR PRIMARY CARE PC
Practice address
363 N Belair Rd
Evans, GA 30809-3096
Phone
(706) 650-7563
Fax
(706) 650-9540
NPI assigned
Jun 23, 2006
Last updated
Jan 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Authorized official

Name
Dr. Robert M Clark, D.O.NPI 1386675890
Title
Ceo
Phone
(706) 650-7563

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

363 N Belair Rd
Evans, GA 30809-3096

Mailing address

PO Box 2510
Evans, GA 30809-2510
Phone (706) 650-7799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040507000258 GA Part B Supplier - Clinic/Group Practice 4385633247 Receives reassigned benefits from 56 practitioners
Practice locations: Augusta, GA; Thomson, GA; North Augusta, SC; Grovetown, GA; Evans, GA
O20040628001320 SC Part B Supplier - Clinic/Group Practice 4385633247 Receives reassigned benefits from 31 practitioners
Practice locations: Aiken, SC; North Augusta, SC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0879221Center for Primary Care-Evans363 North Belair Road, Evans, GA 30809AccreditationDec 9, 2026

National Provider Directory

National Provider Directory

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Locations

1701 Magnolia Way
Ste 102
Augusta, GA 30909
Phone (706) 922-6699

254 Furys Ferry Rd
Augusta, GA 30907
Phone (706) 986-0999

363 N Belair Rd
Evans, GA 30809
Phone (706) 650-7563

4039 Gateway Blvd
Grovetown, GA 30813
Phone (706) 498-9570

131 Rinehart Way
Aiken, SC 29803
Phone (803) 335-2200

105 E Hugh St
Ste B
North Augusta, SC 29841
Phone (803) 426-2000

Practitioners & affiliated clinicians

Practitioners 70

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.

View all 70

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736726400000",
    "number": "1316973472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2510",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308092510",
            "telephone_number": "706-650-7799",
            "fax_number": "706-650-9540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 N BELAIR RD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093096",
            "telephone_number": "706-650-7563",
            "fax_number": "706-650-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PRIMARY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-650-7563",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.