NPIMap

Organization Active NPI

Prosperity Medical and Health System, LLC

  • Primary Care Clinic/Center
  • Laurel, MD
National Provider Identifier
1396491056
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PROSPERITY MEDICAL AND HEALTH SYSTEM, LLC
Practice address
13922 Baltimore Ave
Laurel, MD 20707-5009
Phone
(301) 483-3333
Fax
(301) 483-3336
NPI assigned
Feb 22, 2022
Last updated
Apr 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Authorized official

Name
Mathias C Bama, MD
Title
Owner
Phone
(301) 483-3333

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU
Primary Care Clinic/Center 261QP2300X NU Primary
Urgent Care Clinic/Center 261QU0200X NU

Addresses

Primary practice location

13922 Baltimore Ave
Laurel, MD 20707-5009

Mailing address

13922 Baltimore Ave
Laurel, MD 20707-5009
Phone (301) 483-3333

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680739200000",
    "number": "1396491056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13922 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075009",
            "telephone_number": "301-483-3333",
            "fax_number": "301-483-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13922 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075009",
            "telephone_number": "301-483-3333",
            "fax_number": "301-483-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPERITY MEDICAL AND HEALTH SYSTEM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-22",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A",
        "authorized_official_last_name": "BAMA",
        "authorized_official_first_name": "MATHIAS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-483-3333",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.