Organization Active NPI

Frederick Primary Care Associates, P.a.

  • Psychiatric/Mental Health Nurse Practitioner
  • Frederick, MD
National Provider Identifier
1083411979
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
FREDERICK PRIMARY CARE ASSOCIATES, P.A.
Practice address
9093 Ridgefield Dr Ste 104
Frederick, MD 21701-6711
Phone
(240) 913-5950
NPI assigned
Feb 27, 2025
Last updated
Jun 23, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
FREDERICK PRIMARY CARE ASSOCIATES, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

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

Authorized official

Name
Scott R Lilly
Title
Ceo
Phone
(301) 663-6162

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

9093 Ridgefield Dr Ste 104
Frederick, MD 21701-6711

Mailing address

610 Solarex CT
Frederick, MD 21703-8624

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2328963Frederick Primary Care Associates9093 Ridgefield Drive #104, Frederick, MD 21701Certificate of waiverAug 19, 2027

National Provider Directory

National Provider Directory
Tax ID family
Frederick Primary Care Associates PA11 organizations share this tax ID, including this one
Part of
Frederick Primary Care Associates PA

Other organizations with this tax ID 10

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

Locations

9093 Ridgefield Dr
Ste 104
Frederick, MD 21701
Phone (240) 913-5950

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1740614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782172800000",
    "number": "1083411979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 SOLAREX CT",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217038624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9093 RIDGEFIELD DR STE 104",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217016711",
            "telephone_number": "240-913-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICK PRIMARY CARE ASSOCIATES, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FREDERICK PRIMARY CARE ASSOCIATES, P.A.",
        "enumeration_date": "2025-02-27",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A",
        "authorized_official_last_name": "LILLY",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-663-6162"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.