NPIMap

Organization Active NPI

Concerted Care Group Frederick LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Frederick, MD
National Provider Identifier
1780107631
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
CONCERTED CARE GROUP FREDERICK LLC
Practice address
92 Thomas Johnson Dr Ste 100
Frederick, MD 21702-4591
Phone
(240) 815-7300
Fax
(301) 500-2223
NPI assigned
Jul 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Authorized official

Name
Keonna Armstrong
Title
VP of Revenue Cycle Management
Phone
(240) 813-9867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

92 Thomas Johnson Dr Ste 100
Frederick, MD 21702-4591

Mailing address

428 E 25TH St
Baltimore, MD 21218-5304
Phone (240) 813-9867

Other identifiers 1

IdentifierTypeStateIssuer
102053OtherMDDHMH OHCQ

National Provider Directory

National Provider Directory
Tax ID family
Concerted Care Group Frederick LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1780107631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 E 25TH ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185304",
            "telephone_number": "240-813-9867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 THOMAS JOHNSON DR STE 100",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024591",
            "telephone_number": "240-815-7300",
            "fax_number": "301-500-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCERTED CARE GROUP FREDERICK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-24",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "ARMSTRONG",
        "authorized_official_first_name": "KEONNA",
        "authorized_official_title_or_position": "VP OF REVENUE CYCLE MANAGEMENT",
        "authorized_official_telephone_number": "240-813-9867"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHMH OHCQ",
            "identifier": "102053",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.