NPIMap

Organization Active NPI

Primary Care Associates of Hagerstown, LLC

  • Internal Medicine Physician
  • Hagerstown, MD
National Provider Identifier
1083803530
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
R100668 Issued in MD
Legal business name
PRIMARY CARE ASSOCIATES OF HAGERSTOWN, LLC
Practice address
354 Mill St
Hagerstown, MD 21740-6138
Phone
(301) 797-0210
Fax
(301) 791-6514
NPI assigned
Oct 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Authorized official

Name
Christine A Feathers, NPNPI 1285635243
Title
Partner
Phone
(301) 797-0210

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X R100668 MD Primary

Addresses

Primary practice location

354 Mill St
Hagerstown, MD 21740-6138

Mailing address

354 Mill St
Hagerstown, MD 21740-6138
Phone (301) 797-0210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110103000018 MD Part B Supplier - Clinic/Group Practice 2264620558 Receives reassigned benefits from 4 practitioners
Practice locations: Hagerstown, MD

National Provider Directory

National Provider Directory

Locations

354 Mill St
Hagerstown, MD 21740
Phone (301) 739-7360

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1083803530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 MILL ST",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406138",
            "telephone_number": "301-797-0210",
            "fax_number": "301-791-6514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 MILL ST",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406138",
            "telephone_number": "301-797-0210",
            "fax_number": "301-791-6514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE ASSOCIATES OF HAGERSTOWN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "FEATHERS",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "301-797-0210",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "R100668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.