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
- Last updated
- Sep 8, 2026
- 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
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
#2C
Randallstown, MD 21133
Phone (410) 701-8485
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, and the practitioner matching its NPPES authorized official.
-
- Primary Care Nurse Practitioner
- Randallstown, MD
- NPI 1972173904
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.