NPIMap

Organization Active NPI

Antietam Family Health LLC

  • Family Nurse Practitioner
  • Hagerstown, MD
National Provider Identifier
1710791348
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
ANTIETAM FAMILY HEALTH LLC
Practice address
1219 Mount Aetna Rd Ste 201
Hagerstown, MD 21742-6550
Phone
(240) 203-8864
NPI assigned
Feb 4, 2025
Last updated
Feb 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Authorized official

Name
Mark Anthony RonconeNPI 1669982872
Title
Owner-Provider
Phone
(240) 203-8864

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Professional Counselor 101YP2500X NU

Addresses

Primary practice location

1219 Mount Aetna Rd Ste 201
Hagerstown, MD 21742-6550

Mailing address

1219 Mount Aetna Rd Ste 201
Hagerstown, MD 21742-6550
Phone (240) 203-8864

National Provider Directory

National Provider Directory
Tax ID family
Antietam Family Health LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1219 Mount Aetna Rd
Ste 201
Hagerstown, MD 21742
Phone (240) 203-8864

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1738627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771891200000",
    "number": "1710791348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 MOUNT AETNA RD STE 201",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426550",
            "telephone_number": "240-203-8864",
            "fax_number": "240-866-8173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 MOUNT AETNA RD STE 201",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426550",
            "telephone_number": "240-203-8864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTIETAM FAMILY HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-04",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A",
        "authorized_official_last_name": "RONCONE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER-PROVIDER",
        "authorized_official_telephone_number": "240-203-8864"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; 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.