Prime Healthcare Services LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

PRIME HEALTHCARE SERVICES LLC

Practice address

4212 Brookside Oaks
Owings Mills, MD 21117-5167

Phone

(202) 320-4133

NPI assigned

Aug 14, 2024

Last updated

Feb 14, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Azizat Adeyiga, NURSE PRACTITIONERNPI 1073065199

Title

DNP

Phone

(202) 320-4133

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Azizat Adeyiga, CRNP

  • Family Nurse Practitioner
  • Owings Mills, MD
  • NPI 1073065199
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739491200000",
    "number": "1952133365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 BROOKSIDE OAKS",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175167",
            "telephone_number": "202-320-4133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 BROOKSIDE OAKS",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175167",
            "telephone_number": "202-320-4133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-14",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A",
        "authorized_official_last_name": "ADEYIGA",
        "authorized_official_first_name": "AZIZAT",
        "authorized_official_title_or_position": "DNP",
        "authorized_official_telephone_number": "202-320-4133",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.