Primecare Physicians of Jacksonville, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

168380 Issued in NC

Legal business name

PRIMECARE PHYSICIANS OF JACKSONVILLE, PLLC

Practice address

29 Office Park Dr
Suite a
Jacksonville, NC 28546-3219

Phone

(910) 353-3000

Fax

(910) 238-4456

NPI assigned

Sep 8, 2010

Last updated

Sep 8, 2010By 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

Dr. Garrett L Rogers, M.D.

Title

Sole Owner

Phone

(910) 353-3000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283904000000",
    "number": "1528375904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 OFFICE PARK DR",
            "address_2": "SUITE A",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285463219",
            "telephone_number": "910-353-3000",
            "fax_number": "910-238-4456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 OFFICE PARK DR",
            "address_2": "SUITE A",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285463219",
            "telephone_number": "910-353-3000",
            "fax_number": "910-238-4456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECARE PHYSICIANS OF JACKSONVILLE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-08",
        "last_updated": "2010-09-08",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "GARRETT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "910-353-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "168380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Internal Medicine Physician in North Carolina

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