NPIMap

Organization Active NPI

Work Life Primary Care LLC

  • Primary Care Clinic/Center
  • Glen Burnie, MD
National Provider Identifier
1669912259
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
C03263 Issued in MD
Legal business name
WORK LIFE PRIMARY CARE LLC
Practice address
7954 Baltimore Annapolis Blvd
Suite 2-C
Glen Burnie, MD 21060-8188
Phone
(410) 487-6052
Fax
(443) 960-4203
NPI assigned
Mar 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Authorized official

Name
Bamoyo Nkongolo, PHYSICIAN ASSISTANT
Title
Owner
Phone
(302) 562-9437

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X C03263 MD Primary

Addresses

Primary practice location

7954 Baltimore Annapolis Blvd
Suite 2-C
Glen Burnie, MD 21060-8188

Mailing address

7954 Baltimore Annapolis Blvd
Suite 2-C
Glen Burnie, MD 21060-8188
Phone (410) 487-6052

National Provider Directory

National Provider Directory

Locations

7954 Baltimore Annapolis Blvd
Ste C
Glen Burnie, MD 21060
Phone (410) 487-6052

NPI Registry JSON

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1669912259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7954 BALTIMORE ANNAPOLIS BLVD",
            "address_2": "SUITE 2-C",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210608188",
            "telephone_number": "410-487-6052",
            "fax_number": "443-960-4203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7954 BALTIMORE ANNAPOLIS BLVD",
            "address_2": "SUITE 2-C",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210608188",
            "telephone_number": "410-487-6052",
            "fax_number": "443-960-4203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WORK LIFE PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "NKONGOLO",
        "authorized_official_first_name": "BAMOYO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-562-9437",
        "authorized_official_credential": "PHYSICIAN ASSISTANT"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MD",
            "license": "C03263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; 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.