Organization Active NPI

Concur Primary Care LLC

  • Internal Medicine Physician
  • Norcross, GA
National Provider Identifier
1366293433
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CONCUR PRIMARY CARE LLC
Practice address
5395 Jimmy Carter Blvd Ste 500a
Norcross, GA 30093-1502
Phone
(470) 822-0101
Fax
(470) 822-3701
NPI assigned
Mar 28, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Authorized official

Name
Nam Huynh, DONPI 1073041695
Title
Owner
Phone
(470) 822-0101

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

5395 Jimmy Carter Blvd Ste 500a
Norcross, GA 30093-1502

Mailing address

11305 Bell Rd Ste 105
Johns Creek, GA 30097-9504
Phone (470) 822-0101

Other practice location 1

11305 Bell Rd Ste 106
Johns Creek, GA 30097-9504
Phone (470) 822-0101

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240613001953 GA Part B Supplier - Clinic/Group Practice 6406399807 Receives reassigned benefits from 3 practitioners
Practice locations: Johns Creek, GA; Norcross, GA

National Provider Directory

National Provider Directory

Locations

11305 Bell Rd
Ste 105
Johns Creek, GA 30097
Phone (470) 822-0101

11305 Bell Rd
Ste 106
Johns Creek, GA 30097
Phone (470) 822-0101

5395 Jimmy Carter Blvd
Ste 500A
Norcross, GA 30093
Phone (470) 822-0101

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717632000000",
    "number": "1366293433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11305 BELL RD STE 105",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300979504",
            "telephone_number": "470-822-0101",
            "fax_number": "470-822-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5395 JIMMY CARTER BLVD STE 500A",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300931502",
            "telephone_number": "470-822-0101",
            "fax_number": "470-822-3701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11305 Bell Rd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Johns Creek",
            "state": "GA",
            "postal_code": "300979504",
            "country_code": "US",
            "telephone_number": "470-822-0101",
            "fax_number": "470-822-3701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CONCUR PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "HUYNH",
        "authorized_official_first_name": "NAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-822-0101",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.