DIVINEGRACE PRIMARY URGENT CARE IV HYDRATION & WELLNESS CLINIC LLC
NPI 1780466771
Nurse Practitioner - Family in Lanham, MD

Q: What is Divinegrace Primary Urgent Care IV Hydration & Wellness Clinic LLC's specialty?

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

Active since October 16, 2023

9420 ANNAPOLIS RD STE 103, LANHAM, MD 20706(240) 476-9409(240) 436-0043 Get Directions Write a Review

NPPES record last updated: June 9, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 22, 2025, Oct 16, 2023 (2 updates tracked since 2023).

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About Divinegrace Primary Urgent Care Iv Hydration & Wellness Clinic Llc NPPES

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

DIVINEGRACE PRIMARY URGENT CARE IV HYDRATION & WELLNESS CLINIC LLC (NPI 1780466771) is a healthcare organization registered as a family in Lanham, Maryland and active in the NPI registry since October 2023. The organization lists Grace Chikezie, Owner, as its authorized official.

NPPES Registry Identity

NPI1780466771

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameDIVINEGRACE PRIMARY URGENT CARE IV HYDRATION & WELLNESS CLINIC LLC

Location Address9420 ANNAPOLIS RD STE 103Lanham, MD 20706-3033

Mailing Address12912 Crossfield DrBeltsville, MD 20705-6334 · (240) 476-9409

Phone(240) 476-9409

Fax(240) 436-0043

Organization SubpartNo

Authorized OfficialGrace ChikezieOwner · (240) 476-9409

Enumeration DateOctober 16, 2023

Last NPPES UpdateJune 9, 20262 updates tracked since enumeration

NPPES CertifiedJune 9, 2026

✔ NPI 1780466771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

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

Taxonomy Code363LF0000X

Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X

9420 ANNAPOLIS RD STE 103, Lanham, MD 20706

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Divinegrace Primary Urgent Care Iv Hydration & Wellness Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Divinegrace Primary Urgent Care IV Hydration & Wellness Clinic LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Grace Chikezie

Nurse Practitioner

NPI 1134797228

8957 EDMONSTON RD STE P
Greenbelt, MD 20770

(609) 225-1255

✔ PECOS✔ Accepts Medicare3.8 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Divinegrace Primary Urgent Care IV Hydration & Wellness Clinic LLC's NPI number?

The NPI number for Divinegrace Primary Urgent Care IV Hydration & Wellness Clinic LLC is 1780466771. It was assigned to this organization in the NPPES registry on October 16, 2023.

Where is Divinegrace Primary Urgent Care IV Hydration & Wellness Clinic LLC located?

Divinegrace Primary Urgent Care IV Hydration & Wellness Clinic LLC is located at 9420 Annapolis Rd Ste 103, Lanham, MD 20706. The listed phone number is (240) 476-9409.

What is Divinegrace Primary Urgent Care IV Hydration & Wellness Clinic LLC's specialty?

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

Is Divinegrace Primary Urgent Care IV Hydration & Wellness Clinic LLC enrolled in Medicare?

Yes. Divinegrace Primary Urgent Care IV Hydration & Wellness Clinic LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Divinegrace Primary Urgent Care IV Hydration & Wellness Clinic LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Divinegrace Primary Urgent Care IV Hydration & Wellness Clinic LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Divinegrace Primary Urgent Care IV Hydration & Wellness Clinic LLC was last updated on June 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.