Prime Healthcare,LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D0058580 Issued in MD

Legal business name

PRIME HEALTHCARE,LLC

Practice address

3233 Superior LN
B21
Bowie, MD 20715-1920

Phone

(301) 805-2500

Fax

(301) 805-0114

NPI assigned

Nov 5, 2007

Last updated

Dec 10, 2007By 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

Dr. Bai Kanu, M.D.NPI 1033163571

Title

Ceo

Phone

(301) 805-2500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

• Bai Kanu, M.D.

  • Internal Medicine Physician
  • Bowie, MD
  • NPI 1033163571

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197244800000",
    "number": "1578743704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3233 SUPERIOR LN",
            "address_2": "B21",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207151920",
            "telephone_number": "301-805-2500",
            "fax_number": "301-805-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3233 SUPERIOR LN",
            "address_2": "B21",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207151920",
            "telephone_number": "301-805-2500",
            "fax_number": "301-805-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-05",
        "last_updated": "2007-12-10",
        "status": "A",
        "authorized_official_last_name": "KANU",
        "authorized_official_first_name": "BAI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-805-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0058580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Prettyman, PT, DPT
• Primal Mental Health Care LLC
• Primary Care Physicians LLC
• Primary Pediatrics
• Prime Healthcare Services LLC
• Natasha E Prince
• Tamika Prince
• Princewell LLC
• Priority Care Inc.
• Prism Therapeutics

• Internal Medicine Physician in Bowie, MD
• Providers in Bowie, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.