NPIMap

Organization Active NPI

Primehealth Behavioral Healthcare Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1518535368
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
PRIMEHEALTH BEHAVIORAL HEALTHCARE SERVICES LLC
Practice address
1501 Sulgrave Ave
Ste 301
Baltimore, MD 21209-3651
Phone
(443) 869-2550
Fax
(443) 869-2750
NPI assigned
Jun 16, 2021
Last updated
May 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Authorized official

Name
Dr. Moses E Ikejiofor, DNPNPI 1437704103
Title
Owner of the Entity
Phone
(443) 869-2550

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X Primary

Addresses

Primary practice location

1501 Sulgrave Ave
Ste 301
Baltimore, MD 21209-3651

Mailing address

3711 Stoneybrook Rd
Randallstown, MD 21133-4134
Phone (443) 869-2550

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL ugostacy@yahoo.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230502000950 MD Part B Supplier - Clinic/Group Practice 0042683393 Receives reassigned benefits from 3 practitioners
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory

Locations

1501 Sulgrave Ave
Ste 301
Baltimore, MD 21209
Phone (443) 869-2550

Practitioners & affiliated clinicians

Practitioners 3

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": "1623801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748476800000",
    "number": "1518535368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3711 STONEYBROOK RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211334134",
            "telephone_number": "443-869-2550",
            "fax_number": "443-869-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SULGRAVE AVE",
            "address_2": "STE 301",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093651",
            "telephone_number": "443-869-2550",
            "fax_number": "443-869-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMEHEALTH BEHAVIORAL HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-16",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A",
        "authorized_official_last_name": "IKEJIOFOR",
        "authorized_official_first_name": "MOSES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER OF THE ENTITY",
        "authorized_official_telephone_number": "443-869-2550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ugostacy@yahoo.com",
            "affiliation": "N",
            "address_1": "3711 Stoneybrook Rd",
            "city": "Randallstown",
            "state": "MD",
            "country_code": "US",
            "postal_code": "211334134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; 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.

Verify at the official NPI Registry.