New Primecare Clinics, Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

38934 Issued in TN

Legal business name

NEW PRIMECARE CLINICS, INC.

Practice address

622 Nuckolls Rd
Bolivar, TN 38008-1532

Phone

(731) 658-2120

Fax

(731) 659-2909

NPI assigned

Apr 8, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Barbara Nkomazana

Title

Manager

Phone

(731) 376-1851

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270684800000",
    "number": "1497071013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 479",
            "city": "MIDDLETON",
            "state": "TN",
            "postal_code": "380520479",
            "telephone_number": "731-658-2120",
            "fax_number": "731-659-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 NUCKOLLS RD",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380081532",
            "telephone_number": "731-658-2120",
            "fax_number": "731-659-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW PRIMECARE CLINICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-08",
        "last_updated": "2010-04-08",
        "status": "A",
        "authorized_official_last_name": "NKOMAZANA",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "731-376-1851",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "38934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Bolivar, TN
• Providers in Bolivar, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; 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.