NPIMap

Organization Active NPI

Frederick Health Medical Group LLC

  • Psychiatry Physician
  • Frederick, MD
National Provider Identifier
1457793424
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
FREDERICK HEALTH MEDICAL GROUP LLC
Practice address
400 W 7TH St
Frederick, MD 21701-4506
Phone
(240) 566-3990
NPI assigned
Jul 19, 2013
Organization subpart
Yes
Parent organization
FREDERICK HEALTH MEDICAL GROUP LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Authorized official

Name
Shelby Boggs
Title
Avp
Phone
(240) 215-6310

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

400 W 7TH St
Frederick, MD 21701-4506

Mailing address

400 W 7TH St
Frederick, MD 21701-4506
Phone (240) 566-3990

Other practice location 1

1562 Opossumtown Pike
Frederick, MD 21702-4920
Phone (240) 215-6310

Other practice location 2

501 W 7th St
Frederick, MD 21701-4586
Phone (240) 215-6310

Other names 3

  • Frederick Health Medical Group Doing business as
  • Monocacy Health Partners Behavioral Health Doing business as
  • Monocacy Health Partners LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130820000555 MD Part B Supplier - Clinic/Group Practice 9931341096 Receives reassigned benefits from 296 practitioners
41 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Frederick, MD; Ijamsville, MD; Mount Airy, MD; Myersville, MD; Walkersville, MD; Adamstown, MD; Brunswick, MD; Emmitsburg, MD

Other NPIs on the same Medicare enrollment 40

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 40

National Provider Directory

National Provider Directory
Tax ID family
Monocacy Health Partners LLC33 organizations share this tax ID, including this one
Part of
Monocacy Health Partners LLC

Other organizations with this tax ID 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1374192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702598400000",
    "number": "1457793424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W 7TH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014506",
            "telephone_number": "240-566-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 7TH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014506",
            "telephone_number": "240-566-3990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1562 Opossumtown Pike",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024920",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 W 7th St",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217014586",
            "country_code": "US",
            "telephone_number": "240-215-6310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FREDERICK HEALTH MEDICAL GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FREDERICK HEALTH MEDICAL GROUP LLC",
        "enumeration_date": "2013-07-19",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A",
        "authorized_official_last_name": "BOGGS",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_title_or_position": "AVP",
        "authorized_official_telephone_number": "240-215-6310"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Frederick Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Monocacy Health Partners Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Monocacy Health Partners Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Monocacy Health Partners LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Dec 15, 2023; 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.

Verify at the official NPI Registry.