Organization Active NPI

Prime Telecare LLC

  • Family Nurse Practitioner
  • Round Rock, TX
National Provider Identifier
1629678347
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
PRIME TELECARE LLC
Practice address
1000 Gattis School Rd Ste 440
Round Rock, TX 78664-3313
Phone
(512) 740-8993
NPI assigned
Oct 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Authorized official

Name
Litty Rose VadakkanNPI 1477807774
Title
Owner
Phone
(512) 400-4025

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

1000 Gattis School Rd Ste 440
Round Rock, TX 78664-3313

Mailing address

1000 Gattis School Rd Ste 440
Round Rock, TX 78664-2569
Phone (512) 740-8993

Other names 1

  • Prime Family Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210204001254 TX Part B Supplier - Clinic/Group Practice 6608280565 Receives reassigned benefits from 1 practitioner
Practice locations: Round Rock, TX

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2238231Prime Telecare LLC, Oba -Prime Family Care1000 Gattis School Road Suite 440, Round Rock, TX 78664Certificate of waiverSep 30, 2027

National Provider Directory

National Provider Directory

Locations

2251 Bagdad Rd
Ste 102
Cedar Park, TX 78613
Phone (512) 740-8993

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22613/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784592000000",
    "number": "1629678347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 GATTIS SCHOOL RD STE 440",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786642569",
            "telephone_number": "512-740-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 GATTIS SCHOOL RD STE 440",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786643313",
            "telephone_number": "512-740-8993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME TELECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-30",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A",
        "authorized_official_last_name": "VADAKKAN",
        "authorized_official_first_name": "LITTY",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-400-4025"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prime Family Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Prime Family Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; 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.