NPIMap

Organization Active NPI

Primal Point LLC

  • Rehabilitation Clinic/Center
  • Parkville, MD
National Provider Identifier
1275241663
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
PRIMAL POINT LLC
Practice address
8713 Harford Rd Ste 102
Parkville, MD 21234-4650
Phone
(410) 870-1590
NPI assigned
Nov 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Authorized official

Name
Ngufor Fube Divine, PMHNP
Title
President
Phone
(410) 870-1590

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

8713 Harford Rd Ste 102
Parkville, MD 21234-4650

Mailing address

8713 Harford Rd Ste 102
Parkville, MD 21234-4650
Phone (410) 870-1590

Other practice location 1

9001 Harford Rd
Parkville, MD 21234-4029
Phone (410) 870-1590

National Provider Directory

National Provider Directory
Tax ID family
Primal Point LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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": "1668384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1275241663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8713 HARFORD RD STE 102",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212344650",
            "telephone_number": "410-870-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8713 HARFORD RD STE 102",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212344650",
            "telephone_number": "410-870-1590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9001 Harford Rd",
            "address_purpose": "LOCATION",
            "city": "Parkville",
            "state": "MD",
            "postal_code": "212344029",
            "country_code": "US",
            "telephone_number": "410-870-1590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIMAL POINT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-14",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "FUBE DIVINE",
        "authorized_official_first_name": "NGUFOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-870-1590",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.