Pleasant Valley Primary Care

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PLEASANT VALLEY PRIMARY CARE

Practice address

20311 Lappans Rd Ste 100
Boonsboro, MD 21713-2086

Phone

(301) 573-9453

NPI assigned

Sep 19, 2022

Last updated

Feb 2, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jessica Roelkey, PHYSICIAN ASSISTANTNPI 1619390424

Title

Owner

Phone

(301) 573-9453

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica Roelkey, PA-C

  • Physician Assistant
  • Boonsboro, MD
  • NPI 1619390424
  Medicare reassignment Care Compare group Authorized official
• David Henry Roelkey V, M.D.

  • Family Medicine Physician
  • Boonsboro, MD
  • NPI 1497927743
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1346962149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20311 LAPPANS RD STE 100",
            "city": "BOONSBORO",
            "state": "MD",
            "postal_code": "217132086",
            "telephone_number": "301-799-1098",
            "fax_number": "301-799-1367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20311 LAPPANS RD STE 100",
            "city": "BOONSBORO",
            "state": "MD",
            "postal_code": "217132086",
            "telephone_number": "301-573-9453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLEASANT VALLEY PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-19",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "ROELKEY",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-573-9453",
        "authorized_official_credential": "PHYSICIAN ASSISTANT"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Pepple, LMSW
• Melissa Ann Phillips, LCSW-C
• Physician's Mobile X-Ray, Inc
• Physician's Mobile X-Ray, Inc
• Jennifer Lee Plantz
• Podiatry Associates PA
• Morgan Pomfrey, PHARMD
• Joanna Stephanie Portillo
• Privia Medical Group, LLC
• Elizabeth Kesecker Proctor

• Family Medicine Physician in Boonsboro, MD
• Providers in Boonsboro, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.