Centennial Primary Care PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

K3664 Issued in TX

Legal business name

CENTENNIAL PRIMARY CARE PLLC

Practice address

5520 Independence Pkwy
Suite 201
Frisco, TX 75035-4606

Phone

(214) 383-0001

Fax

(214) 383-0068

NPI assigned

May 8, 2012

Organization subpart

No

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

Authorized official

Name

Nuzhat F Ahmed, MDNPI 1275517799

Title

Managing Director

Phone

(512) 656-1050

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

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

• Nuzhat F. Ahmed, MD

  • Internal Medicine Physician
  • Plano, TX
  • NPI 1275517799
  Medicare reassignment NPD Authorized official
• Amanda B Paul, PA-C

  • Medical Physician Assistant
  • Plano, TX
  • NPI 1912259755
  NPD

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342828800000",
    "number": "1831458132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5520 INDEPENDENCE PKWY",
            "address_2": "SUITE 201",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750354606",
            "telephone_number": "214-383-0001",
            "fax_number": "214-383-0068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 INDEPENDENCE PKWY",
            "address_2": "SUITE 201",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750354606",
            "telephone_number": "214-383-0001",
            "fax_number": "214-383-0068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-08",
        "last_updated": "2012-07-21",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "NUZHAT",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "512-656-1050",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K3664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Celebrity Home Care
• Centennial ASC, LLC (Baylor Surgicare at Centennial)
• Centennial OB GYN PA
• Centennial OB GYN, P.a.
• Centennial Pediatrics
• Center for Assisted Reproduction
• Center for Assisted Reproduction Laboratory and Surgery Center Inc
• Center for Marriage and Family Counseling
• Centra Diagnostics - Texas LLC
• Miguel Cepeda-Sanchez

• Internal Medicine Physician in Frisco, TX
• Providers in Frisco, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2012; 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.