PERIDOT PRIMARY CARE, LLC
NPI 1356957252
Nurse Practitioner - Family in Clarksburg, MD

Q: What is Peridot Primary Care, LLC's NPI number?

The NPI number for Peridot Primary Care, LLC is 1356957252. It was assigned to this organization in the NPPES registry on September 17, 2020. The provider was formerly known as True Vitality Consulting, LLC.

Q: What is Peridot Primary Care, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since September 17, 2020CLIA 21D2206389 · Waiver

23202 BREWERS TAVERN WAY, CLARKSBURG, MD 20871(301) 215-2309(855) 942-3275 Get Directions Write a Review

NPPES record last updated: January 11, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 11, 2022, Nov 6, 2021, Oct 22, 2021 and 7 more (10 updates tracked since 2020).

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About Peridot Primary Care, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PERIDOT PRIMARY CARE, LLC (NPI 1356957252), doing business as True Vitality Consulting, Llc, is a healthcare organization registered as a family in Clarksburg, Maryland and active in the NPI registry since September 2020. The organization holds a CLIA Waiver certificate valid through December 17, 2026 and lists Princess Stephenson, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1356957252

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NamePERIDOT PRIMARY CARE, LLC

Location Address23202 BREWERS TAVERN WAYClarksburg, MD 20871-4391

Mailing Address23202 Brewers Tavern WayClarksburg, MD 20871-4391 · (301) 298-9919 · Fax (301) 298-9917

Phone(301) 215-2309

Fax(855) 942-3275

Organization SubpartNo

Authorized OfficialPrincess StephensonManaging Member · (301) 298-9919

Enumeration DateSeptember 17, 2020

Last NPPES UpdateJanuary 11, 202210 updates tracked since enumeration

NPPES CertifiedJanuary 11, 2022

✔ NPI 1356957252 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

23202 BREWERS TAVERN WAY, Clarksburg, MD 20871

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Other Names 1

Former Legal Business NameTrue Vitality Consulting, Llc

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D2206389

Peridot Primary Care LLC · Clarksburg, MD

Active · expires Dec 17, 2026

CLIA Number21D2206389

Laboratory TypePhysician Office

Certificate Effective DateDecember 18, 2024

Certificate Expiration DateDecember 17, 2026

Laboratory DirectorPrincess Stephenson

Laboratory Phone(301) 215-2309

Laboratory LocationPeridot Primary Care LLC23202 Brewers Tavern Way, Clarksburg, MD 20871

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SSV MEDICAL GROUP

Clinic/Center (Primary Care)