NPIMap

Organization Active NPI

Primal Pointe Health LLC

  • Psychiatry Physician
  • Baltimore, MD
National Provider Identifier
1104405505
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PRIMAL POINTE HEALTH LLC
Practice address
8713 Harford Rd Ste 102
Baltimore, MD 21234-4650
Phone
(240) 423-8757
NPI assigned
Apr 5, 2021
Organization subpart
Yes
Parent organization
PRIMAL HEALTH CLINIC LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Authorized official

Name
Jane Mwangi, NPNPI 1699107250
Title
Owner
Phone
(443) 600-0181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

8713 Harford Rd Ste 102
Baltimore, MD 21234-4650

Mailing address

8713 Harford Rd Ste 102
Baltimore, MD 21234-4650
Phone (240) 423-8757

National Provider Directory

National Provider Directory
Tax ID family
Primal Pointe Health2 organizations share this tax ID, including this one
Part of
Primal Pointe Health

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1104405505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8713 HARFORD RD STE 102",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212344650",
            "telephone_number": "240-423-8757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8713 HARFORD RD STE 102",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212344650",
            "telephone_number": "240-423-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMAL POINTE HEALTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIMAL HEALTH CLINIC LLC",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "MWANGI",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-600-0181",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.