Free State Primary Care LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

FREE STATE PRIMARY CARE LLC

Practice address

741 Annapolis Rd
Gambrills, MD 21054-1308

Phone

(240) 647-9049

NPI assigned

Aug 8, 2023

Organization subpart

No

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

Authorized official

Name

Jennifer Sunday

Title

Office Manager

Phone

(301) 788-2427

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1013690965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 W PATRICK ST FL 205",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217015093",
            "telephone_number": "240-647-9049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 ANNAPOLIS RD",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541308",
            "telephone_number": "240-647-9049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "43 Community Pl",
            "address_purpose": "LOCATION",
            "city": "Crownsville",
            "state": "MD",
            "postal_code": "210322034",
            "country_code": "US",
            "telephone_number": "240-647-9049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FREE STATE PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "SUNDAY",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "301-788-2427"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.