| NPI | 1356957252 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2020-09-17 |
| Last Updated | 2022-01-11 |
| Authorized Official | Princess Stephenson Managing Member Phone: 3012989919 |
| Mailing Address | 23202 Brewers Tavern Way Clarksburg, MD 20871-4391 United States Phone: (301) 298-9919 | Fax: (301) 298-9917 📍 View Map |
| Primary Practice Address | 23202 Brewers Tavern Way Clarksburg, MD 20871-4391 United States Phone: (301) 215-2309 | Fax: (855) 942-3275 📍 View Map |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 363LF0000X – Nurse Practitioner, Family | - | - |
Use our free NPI Lookup tool to find any healthcare provider in the NPPES registry. Search NPI →
About NPI 1356957252
Peridot Primary Care, Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1356957252. The primary specialty listed is Nurse Practitioner, Family. The organization is located in Clarksburg, MD. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2020-09-17. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1356957252?
NPI 1356957252 belongs to Peridot Primary Care, Llc, a Nurse Practitioner, Family in Clarksburg, MD. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1356957252 active?
The current status of NPI 1356957252 in the NPPES registry is Active. The record was last updated on 2022-01-11.
What specialty is NPI 1356957252?
NPI 1356957252 is classified under the taxonomy Nurse Practitioner, Family. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1356957252?
You can verify NPI 1356957252 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1356957252?
The primary practice address on file for NPI 1356957252 is 23202 Brewers Tavern Way, Clarksburg, MD 20871-4391. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1356957252 issued?
NPI 1356957252 was first issued (enumerated) on 2020-09-17. The NPPES record was last updated on 2022-01-11.
Practice Location Map
Peridot Primary Care, Llc is located at 23202 Brewers Tavern Way, Clarksburg, MD. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Peridot Primary Care, Llc. All records sourced from the CMS NPPES registry.