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DR K PRIMARY CARE
NPI 1215689757
Family Medicine in Port Orange, FL

Active since January 26, 2022CLIA 10D2264565 · Waiver
3801 WOODBRIAR TRL, PORT ORANGE, FL 32129(386) 382-7177 Get Directions Write a Review

NPPES record last updated: June 22, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 8, 2022, Jan 26, 2022 (2 updates tracked since 2022).

About Dr K Primary Care NPPES

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

DR K PRIMARY CARE (NPI 1215689757) is a healthcare organization registered as a family medicine in Port Orange, Florida and active in the NPI registry since January 2022. The organization holds a CLIA Waiver certificate valid through July 14, 2028 and lists Samira Karakossian, Owner, as its authorized official.

NPPES Registry Identity

NPI1215689757
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameDR K PRIMARY CARE, LLC
Location Address3801 WOODBRIAR TRLPort Orange, FL 32129-9627
Mailing AddressPo Box 612New Smyrna Beach, FL 32170-0612 · (386) 382-7177
Phone(386) 382-7177
Organization SubpartNo
Authorized OfficialSamira KarakossianOwner · (386) 382-7177
Enumeration DateJanuary 26, 2022
Last NPPES UpdateJune 22, 20222 updates tracked since enumeration
NPPES CertifiedJune 22, 2022
✔ NPI 1215689757 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3801 WOODBRIAR TRL, Port Orange, FL 32129
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Other Names 1

Doing Business AsDr K Primary Care

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Waiver 10D2264565

Dr K Primary Care · Port Orange, FL
Active · expires Jul 14, 2028
CLIA Number10D2264565
Laboratory TypePhysician Office
Certificate Effective DateJuly 15, 2026
Certificate Expiration DateJuly 14, 2028
Laboratory DirectorVartan Karakossian
Laboratory Phone(386) 382-7177
Laboratory LocationDr K Primary Care3801 Woodbriar Trail, Port Orange, FL 32129
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Dr K Primary Care, LLC's NPI number?

The NPI number for Dr K Primary Care, LLC is 1215689757. It was assigned to this organization in the NPPES registry on January 26, 2022. The provider is doing business as Dr K Primary Care.

Where is Dr K Primary Care, LLC located?

Dr K Primary Care, LLC is located at 3801 Woodbriar Trl, Port Orange, FL 32129. The listed phone number is (386) 382-7177.

What is Dr K Primary Care, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Dr K Primary Care, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2264565) is associated with this NPI, valid through July 14, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Dr K Primary Care, LLC was last updated on June 22, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.