NPIMap

Organization Active NPI

Concierge Medical LLC

  • Primary Care Clinic/Center
  • Ellicott City, MD
National Provider Identifier
1396640025
Registry record updated Oct 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CONCIERGE MEDICAL LLC
Practice address
3459 Saint Johns LN Ste 4
Ellicott City, MD 21042-4025
Phone
(301) 256-7200
NPI assigned
Oct 12, 2026
Last updated
Oct 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2026

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

Authorized official

Name
Viviane Flora Dicoum, FNPNPI 1699039057
Title
Nurse Practitioner
Phone
(301) 256-7200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

3459 Saint Johns LN Ste 4
Ellicott City, MD 21042-4025

Mailing address

8604 Briarwood CT
Laurel, MD 20708-1320
Phone (301) 256-7200

National Provider Directory

National Provider Directory

Locations

3459 Saint Johns Ln
Ste 4
Ellicott City, MD 21042
Phone (301) 909-8150

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1791763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791763200000",
    "number": "1396640025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8604 BRIARWOOD CT",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207081320",
            "telephone_number": "301-256-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3459 SAINT JOHNS LN STE 4",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210424025",
            "telephone_number": "301-256-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCIERGE MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-12",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A",
        "authorized_official_last_name": "DICOUM",
        "authorized_official_first_name": "VIVIANE",
        "authorized_official_middle_name": "FLORA",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "301-256-7200",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2026; 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.