Prime Health and Wellness LLC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

Legal business name

PRIME HEALTH AND WELLNESS LLC

Practice address

6200 Baltimore Ave Ste 300-24
Riverdale Park, MD 20737-1054

Phone

(240) 436-0550

Fax

(301) 962-2884

NPI assigned

Dec 19, 2024

Organization subpart

No

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

Authorized official

Name

Carine Ndeko, NPNPI 1306321443

Title

Owner

Phone

(240) 436-0550

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Carine Gouetso Ndeko, CRNP-ADULT

  • Primary Care Nurse Practitioner
  • Glen Burnie, MD
  • NPI 1306321443
  NPD Authorized official

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

{
    "created_epoch": "1734566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743552000000",
    "number": "1730997065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 BALTIMORE AVE STE 300-24",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 BALTIMORE AVE STE 300-24",
            "city": "RIVERDALE PARK",
            "state": "MD",
            "postal_code": "207371054",
            "telephone_number": "240-436-0550",
            "fax_number": "301-962-2884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6200 Baltimore Ave Ste 300-24",
            "address_purpose": "LOCATION",
            "city": "Riverdale",
            "state": "MD",
            "postal_code": "207371054",
            "country_code": "US",
            "telephone_number": "301-962-2884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIME HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-19",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A",
        "authorized_official_last_name": "NDEKO",
        "authorized_official_first_name": "CARINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-436-0550",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Health Nurse Practitioner in Riverdale Park, MD
• Providers in Riverdale Park, MD by specialty
• Adult Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; 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.