MTK Primary Care Medical Group

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

MTK PRIMARY CARE MEDICAL GROUP

Practice address

1835A S Centre City Pkwy Ste 459
Escondido, CA 92025

Phone

(619) 677-2788

Fax

(619) 259-2334

NPI assigned

Oct 17, 2017

Last updated

Jun 20, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tari Keeme

Title

Owner

Phone

(858) 263-8623

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Denise Marie Reppenhagen, NP

  • Adult Health Nurse Practitioner
  • Carlsbad, CA
  • NPI 1760703136
  NPD (past)

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

{
    "created_epoch": "1508198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1427569581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835A S CENTRE CITY PKWY STE 459",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920256525",
            "telephone_number": "619-677-2788",
            "fax_number": "619-259-2334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835A S CENTRE CITY PKWY STE 459",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "92025",
            "telephone_number": "619-677-2788",
            "fax_number": "619-259-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MTK PRIMARY CARE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-17",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "KEEME",
        "authorized_official_first_name": "TARI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-263-8623"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Syed M Mousavi, MD
• Mouths of Babes Lactation Services LLC
• Okiemute Mowoe
• Imelda Moya-Magana, LPCC 18053
• Alicia Michelle Moyer
• Joseph Peter Muga, PH.D.
• Cameron Mulcahey
• Nicole B Mulder, MD
• Mary Muller
• Nicole Catherine Muller, PH.D.

• Specialist in Escondido, CA
• Providers in Escondido, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.