Percival Carlos Hargrove, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C0005080 Issued in MD

Practice address

1060 W Perimeter Rd
JB Andrews, MD 20762-6602

Phone

(240) 612-1856

NPI assigned

Dec 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1770560450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13309 WHITAKER PARK DR",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206135688",
            "telephone_number": "302-331-7277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 W PERIMETER RD",
            "city": "JB ANDREWS",
            "state": "MD",
            "postal_code": "207626602",
            "telephone_number": "240-612-1856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGROVE",
        "first_name": "PERCIVAL",
        "middle_name": "CARLOS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0005080",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "C0005080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grant William Griffith, D.O.
• Scott R Griffith, M.D.
• Michael Groden
• Raquel Tanzswa Hall, PHYSICIAN ASSISTANT
• Daniel Joseph Halse Jr., DDS
• Amanda Marie Hawkins, MD
• Patricia Banaszek Hazard, CRNP
• Healing Roots Together LLC
• Erica Heffner
• Chrystal Dilworth Henderson, M.D.

• Family Medicine Physician in JB Andrews, MD
• Providers in JB Andrews, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.