PRUDENT MEDICAL ASSOCIATES LLC NPI 1932541786

NPI Information

NPI: 1932541786
Provider Name: PRUDENT MEDICAL ASSOCIATES LLC
Classification: Nurse Practitioner - 363LF0000X
Specialization: Family
Entity Type: Organization
Doing Business As: PRUDENT MEDICAL ASSOCIATES
CLIA Number: 09D2068760
Address: 7100 BALTIMORE AVE STE 510
COLLEGE PARK, MD
ZIP 20740
Phone: (240) 467-5739

Map and Directions

Get Directions

NPI Details

PRUDENT MEDICAL ASSOCIATES LLC is a family nurse practitioner in College Park, MD. PRUDENT MEDICAL ASSOCIATES LLC NPI is 1932541786. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Prudent Medical Associates.

The provider's business location address is:

7100 BALTIMORE AVE STE 510
COLLEGE PARK, MD
ZIP 20740-641
Phone: (240) 467-5739
Fax: (240) 467-5795

The provider's authorized official is Deborah I Okonofua .
The authorized official title is Owner and has the following contact phone number (301) 254-8509.

The CLIA number assigned to this NPI record is 09D2068760 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/22/2013 and was last updated on 12/7/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	RN1003033	DISTRICT OF COLUMBIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	080802600	MEDICAID	DISTRICT OF COLUMBIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI

Next NPI