Primary Elite Healthcare, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

PRIMARY ELITE HEALTHCARE, LLC

Practice address

9627 Eaves Drive
Owings Mills, MD 21117

Phone

(443) 744-6214

NPI assigned

Feb 26, 2021

Organization subpart

No

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

Authorized official

Name

Theressa Williams, CRNPNPI 1922514348

Title

NP

Phone

(443) 744-6214

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Theressa Williams, CRNP

  • Family Nurse Practitioner
  • Baltimore, MD
  • NPI 1922514348
  NPD Authorized official

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

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614297600000",
    "number": "1568056802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9627 EAVES DR",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175919",
            "telephone_number": "443-744-6214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9627 EAVES DRIVE",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "21117",
            "telephone_number": "443-744-6214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY ELITE HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-26",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "THERESSA",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "443-744-6214",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689148256",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922514348",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Prime Healthcare Services LLC
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• Privia Medical Group, LLC
• Privia Medical Group, LLC

• Family Nurse Practitioner in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; 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.