Organization Active NPI

Dynamic Primary Care Practice LLC

  • Family Nurse Practitioner
  • Natick, MA
National Provider Identifier
1750151205
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
DYNAMIC PRIMARY CARE PRACTICE LLC
Practice address
67 Union St Unit 305
Natick, MA 01760-7700
Phone
(508) 479-8038
NPI assigned
Jan 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
Chikaebere C Toure, MSN, CNP, FNP-BCNPI 1326798026
Title
President
Phone
(617) 458-2002

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

67 Union St Unit 305
Natick, MA 01760-7700

Mailing address

67 Union St Unit 305
Natick, MA 01760-7700
Phone (508) 479-8038

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240228002461 MA Part B Supplier - Clinic/Group Practice 6305281478 Receives reassigned benefits from 1 practitioner
Practice locations: Natick, MA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D2309297Dynamic Primary Care Practice, LLC67 Union Street, Unit 305, Natick, MA 01760Certificate of waiverAug 12, 2026

National Provider Directory

National Provider Directory

Locations

67 Union St
Unit 305
Natick, MA 01760
Phone (508) 479-8038

20 Hope Ave
Unit 322
Waltham, MA 02453

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1704412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1750151205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 UNION ST UNIT 305",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017607700",
            "telephone_number": "508-479-8038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 UNION ST UNIT 305",
            "city": "NATICK",
            "state": "MA",
            "postal_code": "017607700",
            "telephone_number": "508-479-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC PRIMARY CARE PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-05",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "TOURE",
        "authorized_official_first_name": "CHIKAEBERE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-458-2002",
        "authorized_official_credential": "MSN, CNP, FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Natick, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.