Individual provider Active NPI

Mary Prim

  • Home Health Aide
  • Cleveland, OH
National Provider Identifier
1720494289
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
0081238 Issued in OH
Practice address
3838 E 146TH St
Cleveland, OH 44128-1021
Phone
(216) 296-0179
NPI assigned
Jul 6, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X
Home Health Aide 374U00000X 0081238 OH Primary
Nurse's AideGroup: 193400000X SINGLE SPECIALTY GROUP 376K00000X 601913700723 OH
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

3838 E 146TH St
Cleveland, OH 44128-1021

Mailing address

428 E 143Rd St Apt 22
Cleveland, OH 44110-1879
Phone (216) 704-7119

Other identifiers 2

IdentifierTypeStateIssuer
0081238MedicaidOH
601913700723OtherOHNURSE AIDE

Other names 1

  • Mary Prim Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0081238OHMDHome Health Aide
601913700723OHMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1404604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1720494289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 E 143RD ST APT 22",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441101879",
            "telephone_number": "216-704-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 E 146TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441281021",
            "telephone_number": "216-296-0179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIM",
        "first_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-06",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "OH",
            "license": "0081238",
            "primary": true
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "601913700723",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0081238",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE AIDE",
            "identifier": "601913700723",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "PRIM",
            "credential": "STNA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; 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.