Organization Active NPI

Carlden Health Family Clinic LLC

  • Family Nurse Practitioner
  • Frederick, MD
National Provider Identifier
1386378388
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
CARLDEN HEALTH FAMILY CLINIC LLC
Practice address
198 Thomas Johnson Dr Ste 103
Frederick, MD 21702-4432
Phone
(301) 447-0710
Fax
(301) 447-0771
NPI assigned
Jul 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Authorized official

Name
Mrs. Dorcas Acheampong, CRNPNPI 1952984775
Title
Certified Registered Nurse Practiti
Phone
(301) 447-0710

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
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

198 Thomas Johnson Dr Ste 103
Frederick, MD 21702-4432

Mailing address

198 Thomas Johnson Dr Ste 103
Frederick, MD 21702-4432
Phone (301) 447-0710

Other identifiers 2

IdentifierTypeStateIssuer
R214555OtherMDMEDICAL LICENSE
1952984775OtherMDNPPES

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230708000003 MD Part B Supplier - Clinic/Group Practice 5799169264 Receives reassigned benefits from 1 practitioner
Practice locations: Frederick, MD

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
21D2286689Carlden Health Family Clinic LLC198 Thomas Johnson Drive Suite 103, Frederick, MD 21702Certificate of waiverAug 1, 2027

National Provider Directory

National Provider Directory

Locations

12410 Milestone Center Dr
Ste 600628
Germantown, MD 20876

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26592/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

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": "1657756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686614400000",
    "number": "1386378388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 THOMAS JOHNSON DR STE 103",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024432",
            "telephone_number": "301-447-0710",
            "fax_number": "301-447-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 THOMAS JOHNSON DR STE 103",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024432",
            "telephone_number": "301-447-0710",
            "fax_number": "301-447-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLDEN HEALTH FAMILY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-14",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A",
        "authorized_official_last_name": "ACHEAMPONG",
        "authorized_official_first_name": "DORCAS",
        "authorized_official_title_or_position": "CERTIFIED REGISTERED NURSE PRACTITI",
        "authorized_official_telephone_number": "301-447-0710",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "R214555",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1952984775",
            "state": "MD"
        }
    ],
    "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 13, 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.