Organization Active NPI

Frisco Primary Care, P.a.

  • Internal Medicine Physician
  • Frisco, TX
National Provider Identifier
1861667685
Registry record updated Mar 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
FRISCO PRIMARY CARE, P.A.
Practice address
4525 Ohio Drive
Frisco, TX 75035
Phone
(972) 731-7717
NPI assigned
Apr 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2011

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

Authorized official

Name
Karen Brown
Title
Administrator
Phone
(972) 731-7717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4525 Ohio Drive
Frisco, TX 75035

Mailing address

4525 Ohio Drive
Frisco, TX 75035
Phone (972) 731-7717

Other identifiers 1

IdentifierTypeStateIssuer
195597301MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080724000739 TX Part B Supplier - Clinic/Group Practice 7517030448 Receives reassigned benefits from 5 practitioners
Practice locations: Frisco, TX

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
45D1083962Frisco Primary Care, PA4525 Ohio Drive Suite 100, Frisco, TX 75035Certificate of waiverMay 12, 2028

National Provider Directory

National Provider Directory

Locations

4525 Ohio Dr
Frisco, TX 75035
Phone (972) 731-7717

4525 Ohio Dr
Ste 100
Frisco, TX 75035
Phone (972) 731-7717

Practitioners & affiliated clinicians

Practitioners 5

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": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300320000000",
    "number": "1861667685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 OHIO DRIVE",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75035",
            "telephone_number": "972-731-7717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 OHIO DRIVE",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "75035",
            "telephone_number": "972-731-7717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRISCO PRIMARY CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2011-03-17",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "972-731-7717"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "195597301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; 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.