NPIMap

Organization Active NPI

FNP-BC Vip Concierge, LLC

  • Primary Care Clinic/Center
  • Oxon Hill, MD
National Provider Identifier
1558832949
Registry record updated Mar 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
FNP-BC VIP CONCIERGE, LLC
Doing business as
Graham Medical Group
NP-VIP Concierge Svc, LLC
Practice address
6178 Oxon Hill Rd Ste 300
Oxon Hill, MD 20745-3123
Phone
(240) 547-9114
Fax
(240) 209-0570
NPI assigned
Dec 10, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2020

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

Authorized official

Name
Maurice Devon Graham, NPNPI 1073965380
Title
Chief Executive Officer
Phone
(240) 210-5520

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
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

6178 Oxon Hill Rd Ste 300
Oxon Hill, MD 20745-3123

Mailing address

8507 Oxon Hill Rd Ste 200-S49
Fort Washington, MD 20744-4766
Phone (240) 547-9114

Other identifiers 1

IdentifierTypeStateIssuer
1073965380MedicaidMD

Other names 2

  • Graham Medical Group Doing business as
  • NP-VIP Concierge Svc, LLC Doing business as

National Provider Directory

National Provider Directory

Locations

8507 Oxon Hill Rd
Ste 200S49
Fort Washington, MD 20744

6178 Oxon Hill Rd
Ste 300
Oxon Hill, MD 20745
Phone (240) 210-5520

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": "1544400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583452800000",
    "number": "1558832949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8507 OXON HILL RD STE 200-S49",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207444766",
            "telephone_number": "240-547-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6178 OXON HILL RD STE 300",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453123",
            "telephone_number": "240-547-9114",
            "fax_number": "240-209-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FNP-BC VIP CONCIERGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-10",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "MAURICE",
        "authorized_official_middle_name": "DEVON",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "240-210-5520",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073965380",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Graham Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NP-VIP Concierge Svc, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oxon Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; 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.