Prime Care Health Services Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PRIME CARE HEALTH SERVICES INC

Practice address

451 E Carson Plaza Dr Ste 101
Carson, CA 90746-3210

Phone

(310) 418-5391

Fax

(310) 381-0039

NPI assigned

Apr 16, 2016

Last updated

Nov 29, 2022By 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

Mr. Augustine Chidebe

Title

President/Ceo

Phone

(310) 418-5391

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346694346. Details of each certification follow.

• CCN 559406 Home health agency · Active · Details

Home health agency certification: CCN 559406

Legal name

PRIME CARE HEALTH SERVICES INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Nov 9, 2020

Last certification

Nov 9, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Mar 28, 2015 in CA

Enrollment address

451 E Carson Plaza Dr
Ste 101
Carson, CA 90746-3210

Listed as

Prime Care Health Services, IncCCN 559406 · All quality measures

Ownership

Proprietary

Certified

Nov 9, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Locations

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Larry U Nwafor Sr., NP

  • Family Nurse Practitioner
  • Los Angeles, CA
  • NPI 1134697576

  W-2 Managing Employee

  CMS ownership
• Ifeoma Nwufor, FNP/PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Gardena, CA
  • NPI 1801325949

  Corporate Director, W-2 Managing Employee

  CMS ownership

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

{
    "created_epoch": "1460764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669680000000",
    "number": "1346694346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 E CARSON PLAZA DR STE 101",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907463210",
            "telephone_number": "424-558-3846",
            "fax_number": "310-381-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 E CARSON PLAZA DR STE 101",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907463210",
            "telephone_number": "310-418-5391",
            "fax_number": "310-381-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME CARE HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-16",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A",
        "authorized_official_last_name": "CHIDEBE",
        "authorized_official_first_name": "AUGUSTINE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "310-418-5391",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Estephania Posada
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• Shana Powe
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• Cartina Marie Price
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• Nancy Quinn

• Home Health Agency in Carson, CA
• Providers in Carson, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.