NPI Code Detail JSON Logo

1477666782 NPI number — PRIMARY HEALTHCARE CENTER, P.C.

NPI Number: 1477666782
Health Care Provider/Practitioner: PRIMARY HEALTHCARE CENTER, P.C.

Information about “1477666782” NPI (PRIMARY HEALTHCARE CENTER, P.C.) exists in 1477666782 in HTML format HTML  |  1477666782 in plain Text format TXT  |  1477666782 in PDF (Portable Document Format) PDF  |  1477666782 in an XML format XML  formats.

NPI Number : 1477666782 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1477666782",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PRIMARY HEALTHCARE CENTER, P.C.",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "644 TALLULAH TRL",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WARNER ROBINS",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "31088",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "478-328-2600",
    "MailingAddressFaxNumber": "478-923-0055",
    "FirstLinePracticeLocationAddress": "644 TALLULAH TRL",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WARNER ROBINS",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "31088-7625",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "478-328-2600",
    "PracticeLocationAddressFaxNumber": "478-923-0055",
    "EnumerationDate": "08/17/2006",
    "LastUpdateDate": "09/11/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "WOOLERY",
    "AuthorizedOfficialFirstName": "WILLIAM",
    "AuthorizedOfficialMiddleName": "A",
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "D.O.",
    "AuthorizedOfficialTelephoneNumber": "478-328-2600",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207Q00000X",
          "TaxonomyName": "Family Medicine Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RN0300X",
          "TaxonomyName": "Nephrology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RP1001X",
          "TaxonomyName": "Pulmonary Disease Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.