Active NPI
J & G Family Practice LLC
- Adult Medicine Physician
- Randallstown, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ngum Avwontom, FNP-BC
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | Primary | ||
| Family Nurse Practitioner | 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 21D2269242 | J & G Family Practice LLC | Certificate of waiver | Sep 21, 2026 |
National Provider Directory
National Provider DirectoryLocations
9331 Liberty Rd
Ste 2D
Randallstown, MD 21133
Interoperability endpoints
- 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.