Active NPI
Concerted Care Group Frederick LLC
- Methadone Clinic
- Frederick, MD
National Provider Identifier
1205359270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Methadone Clinic
- License
- 102053
- Legal business name
- CONCERTED CARE GROUP FREDERICK LLC
- Practice address
- 92 Thomas Johnson Dr Ste 100
Frederick, MD 21702-4591 - Phone
- (240) 815-7300
- Fax
- (301) 500-2223
- NPI assigned
- Jul 21, 2017
- Last updated
- Jan 22, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Keonna Armstrong
- Title
- VP of Revenue Cycle Management
- Phone
- (240) 813-9867
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Methadone Clinic | 261QM2800X | 102053 | Primary |
Addresses
Primary practice location
92 Thomas Johnson Dr Ste 100
Frederick, MD 21702-4591
Mailing address
428 E 25TH St
Baltimore, MD 21218-5304
Phone (240) 813-9867
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 102053 | Other | MD | DHMH OHCQ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Opioid treatment program
- Medicare-enrolled since Jan 1, 2020
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191217000693 | MD | Part B Supplier - Opioid Treatment Program (Otp) | 3971937426 | Practice locations: Frederick, MD |
National Provider Directory
National Provider Directory- Tax ID family
- Concerted Care Group Frederick LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Frederick, MD
- NPI 1306458732
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Frederick, MD
- NPI 1780107631
Locations
300 Scholls Ln
Frederick, MD 21701
Phone (301) 600-3102
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500595200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1737504000000",
"number": "1205359270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "428 E 25TH ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212185304",
"telephone_number": "240-813-9867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "92 THOMAS JOHNSON DR STE 100",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217024591",
"telephone_number": "240-815-7300",
"fax_number": "301-500-2223"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CONCERTED CARE GROUP FREDERICK LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-07-21",
"last_updated": "2025-01-22",
"certification_date": "2025-01-22",
"status": "A",
"authorized_official_last_name": "ARMSTRONG",
"authorized_official_first_name": "KEONNA",
"authorized_official_title_or_position": "VP OF REVENUE CYCLE MANAGEMENT",
"authorized_official_telephone_number": "240-813-9867"
},
"taxonomies": [
{
"code": "261QM2800X",
"taxonomy_group": "",
"desc": "Clinic/Center, Methadone",
"state": null,
"license": "102053",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DHMH OHCQ",
"identifier": "102053",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Frederick, MD
- Comprehensive Neurology Services, P.a.
- Comprehensive Neurology Services, P.a.
- Comprehensive Neuropsych Services
- Comprehensive Primary Care and Associates, LLC
- Comprehensive Rehab Consultants PLLC
- Concerted Care Group Frederick LLC
- Concerted Care Group Frederick LLC
- Janice Condrey, RN, BSN
- Congruent Counseling Services LLC
- Megan Elizabeth Conklin, PA-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.