PRIMECARE MEDICAL CENTER
NPI 1013974864
Clinic/Center - Primary Care in Charlotte, NC

Q: What is Bomray Medical Clinic's NPI number?

The NPI number for Bomray Medical Clinic is 1013974864. It was assigned to this organization in the NPPES registry on April 26, 2006. The provider is doing business as Primecare Medical Center.

Q: What is Bomray Medical Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Active since April 26, 2006CLIA 34D0940480 · Accreditation

3627 BEATTIES FORD RD, CHARLOTTE, NC 28216(704) 335-0806(704) 334-2073 Get Directions Write a Review

NPPES record last updated: July 20, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Primecare Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIMECARE MEDICAL CENTER (NPI 1013974864) is a healthcare organization registered as a primary care in Charlotte, North Carolina and active in the NPI registry since April 2006. The organization holds an CLIA Accreditation certificate valid through November 10, 2026 and lists Jerri Olszewski, Billing Representative, as its authorized official.

NPPES Registry Identity

NPI1013974864

Entity TypeOrganization

Primary Taxonomy261QP2300X

Legal Business NameBOMRAY MEDICAL CLINIC

Location Address3627 BEATTIES FORD RDCharlotte, NC 28216-3249

Mailing Address3627 Beatties Ford RdCharlotte, NC 28216-3249 · (704) 335-0806 · Fax (704) 334-2073

Phone(704) 335-0806

Fax(704) 334-2073

Organization SubpartNo

Authorized OfficialJerri OlszewskiBilling Representative · (704) 335-0806

Enumeration DateApril 26, 2006

Last NPPES UpdateJuly 20, 2010

✔ NPI 1013974864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities

Taxonomy Code261QP2300X

Also ListedClinic/CenterTaxonomy 261Q00000X

Also ListedClinic/Center · Health ServiceTaxonomy 261QH0100X

Also ListedClinic/Center · Student HealthTaxonomy 261QS1000X

Also ListedClinic/Center · Urgent CareTaxonomy 261QU0200X

3627 BEATTIES FORD RD, Charlotte, NC 28216

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Other Names 1

Doing Business AsPrimecare Medical Center

Other Identifiers 2

Medicaid890271WNC

Medicare ID-Type Unspecified2321578NC · Provider Medicare Id

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 34D0940480

Prime Care Medical Center · Charlotte, NC

Active · expires Nov 10, 2026

CLIA Number34D0940480

Laboratory TypePhysician Office

Certificate Effective DateNovember 11, 2024

Certificate Expiration DateNovember 10, 2026

Laboratory DirectorPatrick Evivie

Laboratory Phone(704) 335-0807

Laboratory LocationPrime Care Medical Center3627 Beatties Ford Road, Charlotte, NC 28216

CLIA data matches this NPI record on: Address

This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALICIA BULLOUGH PA-C

Physician Assistant