NPIMap

Organization Active NPI

Prime Home Healthcare LLC

  • Home Health Agency
  • Columbia, MD
National Provider Identifier
1962252890
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PRIME HOME HEALTHCARE LLC
Practice address
10910 Little Patuxent Pkwy Ste 204
Columbia, MD 21044-3092
Phone
(301) 404-4898
Fax
(301) 901-5270
NPI assigned
Mar 25, 2024
Last updated
Mar 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Authorized official

Name
Mohammed Jawara, PTA
Title
Vice President
Phone
(301) 404-4898

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

10910 Little Patuxent Pkwy Ste 204
Columbia, MD 21044-3092

Mailing address

11434 High Hay Dr
Columbia, MD 21044-1027
Phone (301) 404-4898

National Provider Directory

National Provider Directory
Tax ID family
Prime Home Healthcare LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711324800000",
    "number": "1962252890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11434 HIGH HAY DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210441027",
            "telephone_number": "301-404-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10910 LITTLE PATUXENT PKWY STE 204",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443092",
            "telephone_number": "301-404-4898",
            "fax_number": "301-901-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HOME HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-24",
        "status": "A",
        "authorized_official_last_name": "JAWARA",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "301-404-4898",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.