Organization Active NPI

Prime Wellness Inc, PC

  • Family Nurse Practitioner
  • Concord, NC
National Provider Identifier
1881476703
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
PRIME WELLNESS INC, PC
Practice address
308 Church St N
Concord, NC 28025-4515
Phone
(704) 803-6510
Fax
(704) 803-6509
NPI assigned
Oct 16, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Authorized official

Name
Patricia Pratt, NPNPI 1437735586
Title
NP
Phone
(704) 803-6510

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

308 Church St N
Concord, NC 28025-4515

Mailing address

308 Church St N
Concord, NC 28025-4515
Phone (704) 803-6510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250128004891 NC Part B Supplier - Clinic/Group Practice 0941739403 Receives reassigned benefits from 1 practitioner
Practice locations: Concord, NC

National Provider Directory

National Provider Directory

Locations

45 Optical Ct NW
Concord, NC 28025
Phone (704) 786-1617

308 Church St N
Concord, NC 28025
Phone (704) 803-6510

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736467200000",
    "number": "1881476703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280254515",
            "telephone_number": "704-803-6510",
            "fax_number": "704-803-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280254515",
            "telephone_number": "704-803-6510",
            "fax_number": "704-803-6509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME WELLNESS INC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-16",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A",
        "authorized_official_last_name": "PRATT",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "NP",
        "authorized_official_telephone_number": "704-803-6510",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.