NPIMap

Organization Active NPI

Prosperity Medical and Health System, LLC

  • Clinical Medical Laboratory
  • Laurel, MD
National Provider Identifier
1053008755
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
PROSPERITY MEDICAL AND HEALTH SYSTEM, LLC
Practice address
13922 Baltimore Ave
Laurel, MD 20707-5009
Phone
(301) 483-3333
NPI assigned
Apr 21, 2023
Last updated
Apr 21, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
PROSPERITY MEDICAL AND HEALTH SYSTEM, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Authorized official

Name
Mathias C Bama
Title
Owner
Phone
(301) 837-8493

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

13922 Baltimore Ave
Laurel, MD 20707-5009

Mailing address

13922 Baltimore Ave
Laurel, MD 20707-5009
Phone (301) 483-3333

National Provider Directory

National Provider Directory
Tax ID family
Prosperity Medical and Health System LLC6 organizations share this tax ID, including this one
Part of
Prosperity Medical and Health System LLC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1053008755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13922 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075009",
            "telephone_number": "301-483-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13922 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075009",
            "telephone_number": "301-483-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPERITY MEDICAL AND HEALTH SYSTEM, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROSPERITY MEDICAL AND HEALTH SYSTEM, LLC",
        "enumeration_date": "2023-04-21",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A",
        "authorized_official_last_name": "BAMA",
        "authorized_official_first_name": "MATHIAS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-837-8493"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.