Familycare Nurse Practitioner LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

FAMILYCARE NURSE PRACTITIONER LLC

Practice address

2300 Garrison Blvd Ste 100
Baltimore, MD 21216-2308

Phone

(410) 945-2289

Fax

(410) 945-4255

NPI assigned

Jan 19, 2020

Organization subpart

No

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

Authorized official

Name

Ngwanma Nwokoro, CRNP

Title

Ceo

Phone

(410) 945-2289

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1579392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579392000000",
    "number": "1821628801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 GARRISON BLVD STE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212162308",
            "telephone_number": "410-945-2289",
            "fax_number": "410-945-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 GARRISON BLVD STE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212162308",
            "telephone_number": "410-945-2289",
            "fax_number": "410-945-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILYCARE NURSE PRACTITIONER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-19",
        "last_updated": "2020-01-19",
        "certification_date": "2020-01-19",
        "status": "A",
        "authorized_official_last_name": "NWOKORO",
        "authorized_official_first_name": "NGWANMA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-945-2289",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "772050500",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://familycarenp.wixsite.com/home",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "eclinical",
            "address_1": "2300 Garrison Blvd Ste 100",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212162308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Primary Care Clinic/Center in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Primary Care Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.