Ngufor Fube Divine, CRNP-PMH

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R241388 Issued in MD

Practice address

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Phone

(210) 808-1859

NPI assigned

Oct 6, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Primal Point LLCGroup PAC ID 8820494958, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Primal Point LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Parkville, MD
  • NPI 1114691672

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD Authorized official
• Bonte Inc

  • Home Health Agency
  • Parkville, MD
  • NPI 1881375582
  NPD Authorized official

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1669197208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9001 HARFORD RD",
            "city": "PARKVILLE",
            "state": "MD",
            "postal_code": "212344029",
            "telephone_number": "410-870-1590",
            "fax_number": "443-558-7706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-808-1859"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8210 Jeremiah Ln",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210444165",
            "country_code": "US",
            "telephone_number": "240-423-8757",
            "fax_number": "301-368-6675",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8713 Harford Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Parkville",
            "state": "MD",
            "postal_code": "212344650",
            "country_code": "US",
            "telephone_number": "443-230-2285",
            "fax_number": "301-368-6675",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9001 Harford Rd",
            "address_purpose": "LOCATION",
            "city": "Parkville",
            "state": "MD",
            "postal_code": "212344029",
            "country_code": "US",
            "telephone_number": "240-423-8757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUBE DIVINE",
        "first_name": "NGUFOR",
        "name_prefix": "Dr.",
        "credential": "CRNP-PMH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-06",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R241388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle H Friedman, MD
• Teresa Anne Friedman, D.O
• Darron K Fritz, PA-C, EMERGENCY MED
• Franklin C Froman, M.S. CCC/A
• Eliane Alumnikanana Fruean
• Andrea Fuller, PT, DPT, SCS
• Charles Alexander Fuller
• Jessica Fuller, LCSW
• Nissa Fuller, PHD, RD, CSG
• Sabrina Fuller, PT

• Psychiatric/Mental Health Nurse Practitioner in Fort Sam Houston, TX
• Providers in Fort Sam Houston, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.