PRIME HEALTH MEDICAL CLINIC, PA
NPI 1063781094
Internal Medicine - Nephrology in Charlotte, NC
About Prime Health Medical Clinic, Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRIME HEALTH MEDICAL CLINIC, PA (NPI 1063781094) is a healthcare organization registered as a nephrology in Charlotte, North Carolina and active in the NPI registry since December 2011. The organization lists Sylvester I Ogbata, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Prime Health Medical Clinic, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Prime Health Medical Clinic, PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Prime Health Medical Clinic, PA's NPI number?
The NPI number for Prime Health Medical Clinic, PA is 1063781094. It was assigned to this organization in the NPPES registry on December 20, 2011.
Where is Prime Health Medical Clinic, PA located?
Prime Health Medical Clinic, PA is located at 1400 Medford Dr, Charlotte, NC 28205. The listed phone number is (704) 940-5588.
What is Prime Health Medical Clinic, PA's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.
Is Prime Health Medical Clinic, PA enrolled in Medicare?
Yes. Prime Health Medical Clinic, PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Prime Health Medical Clinic, PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nephrology) reassigns their Medicare billing to Prime Health Medical Clinic, PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Prime Health Medical Clinic, PA was last updated on September 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Prime Health Medical Clinic, Pa · NPI 1063781094
Nephrology organization in Charlotte, North Carolina. Organization record, active in the CMS NPPES registry since December 20, 2011.
## Identity
- **NPI:** 1063781094 (Entity type: Organization)
- **Enumerated:** December 20, 2011
- **Primary specialty:** Internal Medicine - Nephrology · taxonomy 207RN0300X
- **Organization subpart:** No
- **Authorized official:** Sylvester Ogbata, OWNER
## Practice location
- **Address:** 1400 MEDFORD DR, Charlotte, NC 28205-5624
- **Phone:** (704) 940-5588 · **Fax:** (704) 940-5589
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nephrology) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 23, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1063781094) · Data from the CMS NPPES public registry.