Active NPI
Prolord Healthcare and Nursing Services
- Adult Health Nurse Practitioner
- Bowie, MD
National Provider Identifier
1205429131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- Legal business name
- PROLORD HEALTHCARE AND NURSING SERVICES
- Practice address
- 13110 3Rd St
Bowie, MD 20720-3745 - Phone
- (301) 675-3270
- Fax
- (240) 202-3783
- NPI assigned
- Feb 11, 2021
- Last updated
- Feb 11, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Oluseyi Sofoluwe, CRNP
- Title
- Owner
- Phone
- (301) 675-3270
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | Primary |
Addresses
Primary practice location
13110 3Rd St
Bowie, MD 20720-3745
Mailing address
13110 3Rd St
Bowie, MD 20720-3745
Phone (301) 675-3270
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 143240100 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613001600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1613001600000",
"number": "1205429131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13110 3RD ST",
"city": "BOWIE",
"state": "MD",
"postal_code": "207203745",
"telephone_number": "301-675-3270",
"fax_number": "240-202-3783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13110 3RD ST",
"city": "BOWIE",
"state": "MD",
"postal_code": "207203745",
"telephone_number": "301-675-3270",
"fax_number": "240-202-3783"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROLORD HEALTHCARE AND NURSING SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2021-02-11",
"last_updated": "2021-02-11",
"certification_date": "2021-02-11",
"status": "A",
"authorized_official_last_name": "SOFOLUWE",
"authorized_official_first_name": "OLUSEYI",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "301-675-3270",
"authorized_official_credential": "CRNP"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Adult Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "143240100",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bowie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.