William Angelo Primos Jr., MD

Primary specialty

Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X

License

42395 Issued in GA

Practice address

108 Prominence CT Ste 200
Dawsonville, GA 30534-6340

Phone

(770) 848-6190

NPI assigned

Nov 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric MedicineAlso: Sports Medicine

Education

University of Mississippi School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Georgia Physicians Group IncGroup PAC ID 6901898386, 884 clinicians

Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tugaloo Home Health Agency, an Amedisy Company Home health agency, Gainesville, GA, CCN 117305
• Northeast Georgia Medical Center, Inc Hospital, Gainesville, GA, CCN 110029

Merit-based Incentive Payment System (MIPS)

Final score

87.83 of 100Reported as group

Quality

80.36

Promoting interoperability

100

Improvement activities

40

Cost

79.08

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wprimos29479@nghs.gadirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northeast Georgia Physicians Group Inc

  • Family Medicine Physician
  • Gainesville, GA
  • NPI 1891745212
  Medicare reassignment Care Compare group NPD
• Children'S Orthopaedics of Atlanta P.C.

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1548247000
  NPD (past)
• Cabarrus Urgent Care

  • Family Medicine Physician
  • Concord, NC
  • NPI 1922037845
  NPD (past)
• Carolinas Physicians Network Inc

  • Family Medicine Physician
  • Huntersville, NC
  • NPI 1508892746
  NPD (past)
• Union Urgent Care LLC

  • Durable Medical Equipment & Medical Supplies
  • Monroe, NC
  • NPI 1063421469
  NPD (past)
• Union Urgent Care LLC

  • Family Medicine Physician
  • Indian Trail, NC
  • NPI 1659380079
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Amedisys Georgia, L.L.C.

  • Home Health Agency
  • Gainesville, GA
  • NPI 1912955667
  Care Compare affiliation
• Northeast Georgia Medical Center, Inc.

  • General Acute Care Hospital
  • Gainesville, GA
  • NPI 1427055821
  Care Compare affiliation

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1528040458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 PROMINENCE CT STE 200",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305346340",
            "telephone_number": "770-848-6190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5445 Meridian Marks Rd NE Ste 250",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303424767",
            "country_code": "US",
            "telephone_number": "404-255-1933",
            "fax_number": "404-256-7924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRIMOS",
        "first_name": "WILLIAM",
        "middle_name": "ANGELO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "NC",
            "license": "39336",
            "primary": false
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "GA",
            "license": "42395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N39665",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "813658737A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8969208",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wprimos29479@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "108 Prominence Ct Ste 200",
            "city": "Dawsonville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305346340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Physiotherapy Associates Inc
• Keila Pitman
• Katie Pittman
• Kevin Lamar Powell, MD
• Primecare Mobility LLC
• Professional Therapy Services, LLC
• Prominence Pharmacy PC
• Prosper Therapy Services, LLC
• Publix Super Markets Inc
• Sherilyn Marie Queen, LMFT

• Pediatric Sports Medicine Physician in Dawsonville, GA
• Providers in Dawsonville, GA by specialty
• Pediatric Sports Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.