Primary Medical Care Group

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

052963 Issued in GA

Legal business name

PRIMARY MEDICAL CARE GROUP

Practice address

5322 Snapfinger Park Dr
Decatur, GA 30035-4040

Phone

(404) 289-9784

Fax

(404) 289-9785

NPI assigned

Dec 19, 2006

Last updated

Mar 29, 2021By 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

Musibau A Ibraheem, MDNPI 1649247834

Title

Physician Owner

Phone

(404) 289-9784

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Musibau A Ibraheem, MD

  • Family Medicine Physician
  • Decatur, GA
  • NPI 1649247834
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616976000000",
    "number": "1689737603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5322 SNAPFINGER PARK DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300354040",
            "telephone_number": "404-289-9784",
            "fax_number": "404-289-9785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5322 SNAPFINGER PARK DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300354040",
            "telephone_number": "404-289-9784",
            "fax_number": "404-289-9785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY MEDICAL CARE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "IBRAHEEM",
        "authorized_official_first_name": "MUSIBAU",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "404-289-9784",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "GA",
            "license": "052963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simone Price
• Thomas Price, M.D.
• Thomas J. Price, D.D.S.
• Bradford Hollace Priddy, M.D.
• Primacare Pain & Rehab.,LLC
• Primary Pathways, LLC
• Prime Care Nursing & Support Services, LLC
• Prime Comfort Transport LLC
• Prime Regen Decatur
• Primrose Home Care & Staffing Solutions LLC

• Adult Medicine Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Adult Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.