Premier Primary Care Center, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

039888 Issued in GA

Legal business name

PREMIER PRIMARY CARE CENTER, INC

Practice address

5820 Old National Hwy
College Park, GA 30349-3838

Phone

(770) 997-1565

Fax

(770) 997-1568

NPI assigned

Mar 8, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Christain C. Ohagwu, M.D.NPI 1083745046

Title

Ceo

Phone

(404) 766-1970

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christain C. Ohagwu, M.D.

  • Internal Medicine Physician
  • College Park, GA
  • NPI 1083745046
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467936000000",
    "number": "1740311711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 OLD NATIONAL HWY",
            "address_2": "SUITE 250",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303493838",
            "telephone_number": "770-997-1565",
            "fax_number": "770-997-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 OLD NATIONAL HWY",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303493838",
            "telephone_number": "770-997-1565",
            "fax_number": "770-997-1568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PRIMARY CARE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2016-07-08",
        "status": "A",
        "authorized_official_last_name": "OHAGWU",
        "authorized_official_first_name": "CHRISTAIN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-766-1970",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "039888",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "039888",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300033306A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10033956",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "52624568002",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in College Park, GA
• Providers in College Park, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.