Organization Active NPI

J & G Family Practice LLC

  • Adult Medicine Physician
  • Randallstown, MD
National Provider Identifier
1700526142
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
J & G FAMILY PRACTICE LLC
Practice address
9331 Liberty Rd # 2C
Randallstown, MD 21133-3525
Phone
(410) 701-8485
Fax
(410) 701-8524
NPI assigned
Apr 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Authorized official

Name
Ngum Avwontom, FNP-BCNPI 1972173904
Title
President
Phone
(301) 404-1989

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

9331 Liberty Rd # 2C
Randallstown, MD 21133-3525

Mailing address

9331 Liberty Rd # 2C
Randallstown, MD 21133-3525
Phone (410) 701-8485

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220621002091 MD Part B Supplier - Clinic/Group Practice 4880073915 Receives reassigned benefits from 1 practitioner
Practice locations: Randallstown, MD

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2269242J & G Family Practice LLC9331 Liberty Rd #2D, Randallstown, MD 21133Certificate of waiverSep 21, 2026

National Provider Directory

National Provider Directory

Locations

9331 Liberty Rd
Ste 2D
Randallstown, MD 21133

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26916/brand/1/csg/1/fhir/r4

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": "1648771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788825600000",
    "number": "1700526142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9331 LIBERTY RD # 2C",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211333525",
            "telephone_number": "410-701-8485",
            "fax_number": "410-701-8524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9331 LIBERTY RD # 2C",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211333525",
            "telephone_number": "410-701-8485",
            "fax_number": "410-701-8524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J & G FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-01",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A",
        "authorized_official_last_name": "AVWONTOM",
        "authorized_official_first_name": "NGUM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-404-1989",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randallstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (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.