A G Medical, LLC – Family Nurse Practitioner

Key facts

NPI: 1669095071
Entity type: Organization (NPI type 2)
Primary specialty: Family Nurse Practitioner 363LF0000X
Legal business name: A G MEDICAL, LLC
Practice address: 915 Seton Dr
Cumberland, MD 21502-1817
Phone: (240) 503-1500
Fax: (240) 503-1501
NPI assigned: May 19, 2020
Organization subpart: No

Authorized official

Name: Ms. Ashley Golden, FNP-BC
Title: Owner
Phone: (304) 813-4111

Practitioners 1

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

Ashley Golden, FNP-BC Family Nurse Practitioner · Cumberland, MD · NPI 1639500598

Medicare reassignment NPD FAMILY · MD

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
21D2186621	Golden Primary Care 915 Seton Drive, Cumberland, MD 21502	Certificate of waiver	Jun 18, 2028

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MD

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20200609000482	MD	Part B Supplier - Clinic/Group Practice	3971924408	Receives reassigned benefits from 1 practitioner Practice locations: Cumberland, MD

National Provider Directory

Locations

915 Seton Dr
Cumberland, MD 21502
Phone (240) 503-1500

Interoperability endpoints

FHIR API: https://api.platform.athenahealth.com/21772/brand/1/csg/1/fhir/r4

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Nurse Practitioner Group: 193400000X SINGLE SPECIALTY GROUP	363LF0000X			Yes

Addresses

Primary practice location

915 Seton Dr
Cumberland, MD 21502-1817

Mailing address

915 Seton Dr
Cumberland, MD 21502-1817
Phone (240) 503-1500

Other identifiers

Identifier	Type	State	Issuer
125430800	Medicaid	MD
1639500598	Other		TYPE I NPI

Other names

Golden Primary Care Doing business as

Other providers in Cumberland, MD

All providers in Cumberland, MD · Family Nurse Practitioner in Maryland

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 30, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.