Active NPI
My Primary Care Clinic Abilene
- Primary Care Clinic/Center
- Abilene, TX
National Provider Identifier
1376309294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- MY PRIMARY CARE CLINIC ABILENE
- Practice address
- 3347 S 2ND St Ste 100
Abilene, TX 79605-1760 - Phone
- (254) 424-3260
- NPI assigned
- Feb 27, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Kyle Karnei, CPA
- Title
- Cfo
- Phone
- (254) 424-3260
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Primary |
Addresses
Primary practice location
3347 S 2ND St Ste 100
Abilene, TX 79605-1760
Mailing address
4438 S Clack St
Abilene, TX 79606-3634
Phone (325) 704-4470
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240801002120 | TX | Part B Supplier - Clinic/Group Practice | 1557808037 |
Receives reassigned benefits from 4 practitioners Practice locations: Abilene, TX |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2300792 | My Primary Care | Certificate of waiver | Mar 14, 2028 |
National Provider Directory
National Provider DirectoryLocations
3347 S 2nd St
#100
Abilene, TX 79605
Phone (325) 275-7824
3347 S 2nd St
Ste 100
Abilene, TX 79605
Phone (254) 424-3260
Practitioners & affiliated clinicians
Practitioners 4
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": "1708992000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1722384000000",
"number": "1376309294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4438 S CLACK ST",
"city": "ABILENE",
"state": "TX",
"postal_code": "796063634",
"telephone_number": "325-704-4470"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3347 S 2ND ST STE 100",
"city": "ABILENE",
"state": "TX",
"postal_code": "796051760",
"telephone_number": "254-424-3260"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MY PRIMARY CARE CLINIC ABILENE",
"organizational_subpart": "NO",
"enumeration_date": "2024-02-27",
"last_updated": "2024-07-31",
"certification_date": "2024-07-31",
"status": "A",
"authorized_official_last_name": "KARNEI",
"authorized_official_first_name": "KYLE",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "254-424-3260",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "CPA"
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Abilene, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; 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.