Primary Addictions Support Services LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R134812 Issued in MD

Legal business name

PRIMARY ADDICTIONS SUPPORT SERVICES LLC

Practice address

260 Gateway Dr Ste 6a
Bel Air, MD 21014-4266

Phone

(443) 987-6481

NPI assigned

Oct 3, 2017

Last updated

Oct 3, 2017By 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

Mrs. Kelly Marie Blosser, CRNPNPI 1295152734

Title

Nurse Practitioner / Owner

Phone

(410) 591-5161

Specialties & licenses 1

Addresses

Locations

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.

• Kelly Blosser, CRNP

  • Acute Care Nurse Practitioner
  • Jarrettsville, MD
  • NPI 1295152734
  NPD (past) Authorized official

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506988800000",
    "number": "1437669629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 KNOPP RD",
            "city": "JARRETTSVILLE",
            "state": "MD",
            "postal_code": "210841614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 GATEWAY DR STE 6A",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144266",
            "telephone_number": "443-987-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY ADDICTIONS SUPPORT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-03",
        "last_updated": "2017-10-03",
        "status": "A",
        "authorized_official_last_name": "BLOSSER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER / OWNER",
        "authorized_official_telephone_number": "410-591-5161",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R134812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Marie Praydis, MS CCC
• Precious Moments Home Care Services, LLC
• Premier Wellness Healthcare
• Monika Emma Preston, LCPC
• George Peter Prevas, PHYSICAL THERAPIST
• Brenda M Prindle, MD
• Privia Medical Group, LLC
• Privia Medical Group, LLC
• PRN Inc
• PRN Inc/ Dog Tag Medical Billing LLC

• Nurse Practitioner in Bel Air, MD
• Providers in Bel Air, MD by specialty
• Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2017; 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.