Tandem Primary Care, PLLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

TANDEM PRIMARY CARE, PLLC

Practice address

105 Newsom St Ste 106
Durham, NC 27704-2197

Phone

(704) 649-1527

Fax

(919) 321-0401

NPI assigned

Nov 9, 2021

Last updated

Mar 28, 2023By 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

Ijeoma Mbanuzue Perkins, MHS, PA-CNPI 1649588989

Title

Ceo

Phone

(919) 321-0418

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

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, and the practitioner matching its NPPES authorized official.

• Ijeoma Mbanuzue Perkins, PA-C

  • Physician Assistant
  • Durham, NC
  • NPI 1649588989
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679961600000",
    "number": "1467118059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 NEWSOM ST STE 106",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 NEWSOM ST STE 106",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042197",
            "telephone_number": "704-649-1527",
            "fax_number": "919-321-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANDEM PRIMARY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-09",
        "last_updated": "2023-03-28",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "PERKINS",
        "authorized_official_first_name": "IJEOMA",
        "authorized_official_middle_name": "MBANUZUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-321-0418",
        "authorized_official_credential": "MHS, PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467118059",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "NC1105O002",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nova Erica Cuevas Tan, PHARM.D.
• Yu Guang Tan, MD
• Kevin Schmidt Tanager, M.D.
• David Tanaka, M.D.
• John Shigeto Tanaka, MD
• Michael Tanedo
• Cynthia Tang, MD, PHD
• Yui-Lin Tang
• Jay Dayalal Tank, M.D.
• Amelia Prieur Tankersley, PHD

• Physician Assistant in Durham, NC
• Providers in Durham, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.