Prince Georges Kidney Care

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

PRINCE GEORGES KIDNEY CARE

Practice address

12200 Annapolis Rd Ste 233
Glenn Dale, MD 20769-9182

Phone

(301) 365-5809

Fax

(301) 365-5813

NPI assigned

Mar 11, 2020

Last updated

Feb 24, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Babak Razi, MD

Title

Owner

Phone

(301) 509-3018

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614124800000",
    "number": "1144855024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 RAINBOW RD",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823727",
            "telephone_number": "301-509-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 ANNAPOLIS RD STE 233",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699182",
            "telephone_number": "301-365-5809",
            "fax_number": "301-365-5813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCE GEORGES KIDNEY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-11",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A",
        "authorized_official_last_name": "RAZI",
        "authorized_official_first_name": "BABAK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-509-3018",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Oscar Porter
• Alphonsie Poumeni
• Pretty Pearls Pediatric Dentistry and Orthodontics, LLC (Scholastic Smiles Pediatric Dentistry Glenn Dale MD)
• Christina Price, ATC
• Prime Medicine LLC
• Priority Behavioral and Mental Health Clinic LLC
• Diana Josiane Priso
• Privia Medical Group, LLC
• Privia Medical Group, LLC
• Privia Medical Group, LLC

• Nephrology Physician in Glenn Dale, MD
• Providers in Glenn Dale, MD by specialty
• Nephrology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.