Primary Health Physicians Group, LLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

PRIMARY HEALTH PHYSICIANS GROUP, LLC

Practice address

655 NW 119TH St
North Miami, FL 33168-2522

Phone

(305) 403-2219

Fax

(786) 517-3620

NPI assigned

Aug 20, 2014

Last updated

Aug 20, 2014By 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. Guy Rudolph Moise, D.O.

Title

President and Ceo

Phone

(305) 403-2219

Specialties & licenses 1

Addresses

Other names 1

• PHPG Other name

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

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408492800000",
    "number": "1548669013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 NW 119TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331682522",
            "telephone_number": "305-403-2219",
            "fax_number": "786-517-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 NW 119TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331682522",
            "telephone_number": "305-403-2219",
            "fax_number": "786-517-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY HEALTH PHYSICIANS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-20",
        "last_updated": "2014-08-20",
        "status": "A",
        "authorized_official_last_name": "MOISE",
        "authorized_official_first_name": "GUY",
        "authorized_official_middle_name": "RUDOLPH",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "305-403-2219",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHPG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Exclusive Provider Organization in North Miami, FL
• Providers in North Miami, FL by specialty
• Exclusive Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; 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.