Organization Active NPI

Primary Care Practitioners and Associates

  • Family Medicine Physician
  • Hallandale Beach, FL
National Provider Identifier
1790739100
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PRIMARY CARE PRACTITIONERS AND ASSOCIATES
Practice address
102 NE 2ND Ave
Hallandale Beach, FL 33009-4212
Phone
(954) 894-0522
Fax
(954) 964-1244
NPI assigned
May 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

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

Authorized official

Name
Mr. Ivory Joe Christen, ARNPNPI 1417952847
Title
Owner
Phone
(954) 894-0522

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 Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X FL Primary

Addresses

Primary practice location

102 NE 2ND Ave
Hallandale Beach, FL 33009-4212

Mailing address

102 NE 2ND Ave
Hallandale Beach, FL 33009-4212
Phone (954) 894-0522

Other identifiers 3

IdentifierTypeStateIssuer
254320600MedicaidFL
207Q00000XOtherFLTAXONOMIES
Y21701OtherFLBC/BS

National Provider Directory

National Provider Directory

Locations

102 NE 2nd Ave
Hallandale Beach, FL 33009
Phone (954) 894-0522

14860 N Miami Ave
North Miami, FL 33168
Phone (305) 354-9117

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": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237852800000",
    "number": "1790739100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 NE 2ND AVE",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094212",
            "telephone_number": "954-894-0522",
            "fax_number": "954-964-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 NE 2ND AVE",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094212",
            "telephone_number": "954-894-0522",
            "fax_number": "954-964-1244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE PRACTITIONERS AND ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2009-03-24",
        "status": "A",
        "authorized_official_last_name": "CHRISTEN",
        "authorized_official_first_name": "IVORY",
        "authorized_official_middle_name": "JOE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-894-0522",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254320600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMIES",
            "identifier": "207Q00000X",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "Y21701",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hallandale Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; 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.