Organization Active NPI

Primary Care Physicians of Gainesville, P.a.

  • Family Medicine Physician
  • Gainesville, FL
National Provider Identifier
1649293648
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
016400509 Issued in FL
Legal business name
PRIMARY CARE PHYSICIANS OF GAINESVILLE, P.A.
Practice address
3780 NW 83Rd St
Gainesville, FL 32606
Phone
(352) 377-2022
Fax
(352) 377-9113
NPI assigned
Jul 25, 2006
Last updated
Aug 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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

Authorized official

Name
Jamie Entrekin
Title
Office Manager
Phone
(352) 377-2022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 016400509 FL Primary

Addresses

Primary practice location

3780 NW 83Rd St
Gainesville, FL 32606

Mailing address

3780 NW 83Rd St
Gainesville, FL 32606-5603
Phone (352) 377-2022

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534377600000",
    "number": "1649293648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3780 NW 83RD ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326065603",
            "telephone_number": "352-377-2022",
            "fax_number": "352-377-9113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3780 NW 83RD ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32606",
            "telephone_number": "352-377-2022",
            "fax_number": "352-377-9113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE PHYSICIANS OF GAINESVILLE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2018-08-16",
        "status": "A",
        "authorized_official_last_name": "ENTREKIN",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "352-377-2022"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "016400509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.