Medical Practices of Antietam LLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

Legal business name

MEDICAL PRACTICES OF ANTIETAM LLC

Practice address

12 St Paul Dr Ste 100
Chambersburg, PA 17201-1035

Phone

(717) 217-6720

NPI assigned

Mar 7, 2025

Last updated

Mar 7, 2025By 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

Joshua Repac

Title

Cfo

Phone

(301) 790-9351

Specialties & licenses 3

Addresses

Tax ID family

Medical Practices of Antietam LLC63 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 1

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Medical Practices of Antietam LLC

  • General Practice Physician
  • Chambersburg, PA
  • NPI 1841098589
  NPD tax ID

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

{
    "created_epoch": "1741305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741305600000",
    "number": "1396543039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS RD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ST PAUL DR STE 100",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172011035",
            "telephone_number": "717-217-6720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PRACTICES OF ANTIETAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-07",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A",
        "authorized_official_last_name": "REPAC",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-790-9351"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Kathleen McNamara
• Heather M McNew, RD, LDN
• Melissa Kay McNew, D.C.
• Med Tel International Corporation (Wide Open Imaging)
• Medexpress Urgent Care, PC - Pennsylvania (MedExpress Urgent Care - Chambersburg)
• Medical Practices of Antietam LLC
• Luis Augusto Medina Mora, M.D.
• Rahul Mehta, DMD
• Michael Meketon, L.C.S.W.
• Kevin R Mello, BS

• Plastic Surgery Physician in Chambersburg, PA
• Providers in Chambersburg, PA by specialty
• Plastic Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.