Individual provider Active NPI

Roger N Ewonkem, M.D.

  • Family Medicine Physician
  • Fort Meade, MD
National Provider Identifier
1821288440
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101244721 Issued in VA
Practice address
2480 Llewellyn Ave
Fort Meade, MD 20755-7081
Phone
(301) 677-8949
NPI assigned
Jul 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101244721 VA Primary

Addresses

Primary practice location

2480 Llewellyn Ave
Fort Meade, MD 20755-7081

Mailing address

7432 Little River Tpke
Annandale, VA 22003-3013
Phone (703) 658-7060

Other practice location 1

7432 Little River Tpke
Annandale, VA 22003-3013
Phone (703) 658-7060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170405001386 DC Practitioner - Family Practice 8921196601 Reassigns benefits to 1 organization
I20210429002169 VA Practitioner - Family Practice 8921196601 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

7432 Little River Tpke
Annandale, VA 22003-3013
Phone (703) 658-7060

9470 Annapolis Rd
Suite 309
Lanham, MD 20706-3022
Phone (202) 832-1800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101244721VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Family Medicine CurrentSince Apr 1, 2021 Accepting new patients
Privia Medical Group, LLC CurrentSince Apr 1, 2021 Accepting new patients
Delaware Valley Hospital, Inc Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Nova Physician Wellness Center PLLC Family Medicine Past Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

7432 Little River Tpke
Annandale, VA 22003
Phone (703) 658-7060

7345 McWhorter Pl
Ste 100
Annandale, VA 22003
Phone (703) 658-7060

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

8644 Sudley Rd
#220
Manassas, VA 20110

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: roger.ewonkem.1@8042.direct.athenahealth.com
  • Direct secure messaging: roger.ewonkemmd.p2@direct.msmg.nextgenshare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1821288440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7432 LITTLE RIVER TPKE",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033013",
            "telephone_number": "703-658-7060",
            "fax_number": "703-658-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 LLEWELLYN AVE",
            "city": "FORT MEADE",
            "state": "MD",
            "postal_code": "207557081",
            "telephone_number": "301-677-8949"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7432 Little River Tpke",
            "address_purpose": "LOCATION",
            "city": "Annandale",
            "state": "VA",
            "postal_code": "220033013",
            "country_code": "US",
            "telephone_number": "703-658-7060",
            "fax_number": "703-658-3150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EWONKEM",
        "first_name": "ROGER",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101244721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Meade, MD

Sources for this page

Verify at the official NPI Registry.