McDonough Primary Care Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MCDONOUGH PRIMARY CARE INC

Practice address

68 Hampton St
McDonough, GA 30253-3150

Phone

(770) 914-0342

Fax

(770) 914-0493

NPI assigned

Nov 10, 2006

Last updated

Nov 9, 2007By 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. William Harrell Van Laar, DONPI 1205909439

Title

Owner

Phone

(770) 914-0342

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Keys Ferry Medical Center Other name

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

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CICCDA

Practitioners 2

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.

• William Harrell Vanlaar, DO

  • Family Medicine Physician
  • McDonough, GA
  • NPI 1205909439
  Medicare reassignment NPD Authorized official
• Jodi Marie Pesce, RN-C,MSN

  • Family Nurse Practitioner
  • McDonough, GA
  • NPI 1417028655
  Medicare reassignment NPD

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1710058953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 HAMPTON ST",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302533150",
            "telephone_number": "770-914-0342",
            "fax_number": "770-914-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 HAMPTON ST",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302533150",
            "telephone_number": "770-914-0342",
            "fax_number": "770-914-0493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCDONOUGH PRIMARY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "VAN LAAR",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "HARRELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-914-0342",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000458455E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keys Ferry Medical Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• McDonough Children's Specialist, P.C.
• McDonough Ga Opco LLC (Westbury Center of McDonough for Nursing & Healing)
• McDonough Internal Medicine
• McDonough Pediatric Dentistry
• McDonough Pediatrics
• McDonough Vision Care LLC
• McDonough Walk-in Healthcare Center
• Valrie McDowell Gunn
• Charlie Lewis McDowell
• Felicia McDowell

• Family Medicine Physician in McDonough, GA
• Providers in McDonough, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; 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.