ANTIETAM FAMILY HEALTH, LLC
NPI 1003693102
Nurse Practitioner - Family in Hagerstown, MD
About Antietam Family Health, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANTIETAM FAMILY HEALTH, LLC (NPI 1003693102) is a healthcare organization registered as a family in Hagerstown, Maryland and active in the NPI registry since September 2023. The organization holds a CLIA Waiver certificate valid through June 5, 2027 and lists Mark Anthony Roncone, Owner/provider, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 21D2283320
Antietam Family Health · Hagerstown, MDOther Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
HAGERSTOWN, MD 21740
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Antietam Family Health, LLC's NPI number?
The NPI number for Antietam Family Health, LLC is 1003693102. It was assigned to this organization in the NPPES registry on September 12, 2023.
Where is Antietam Family Health, LLC located?
Antietam Family Health, LLC is located at 221 E Baltimore St, Hagerstown, MD 21740. The listed phone number is (240) 203-8864.
What is Antietam Family Health, LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Does Antietam Family Health, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 21D2283320) is associated with this NPI, valid through June 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Antietam Family Health, LLC was last updated on September 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Antietam Family Health, Llc · NPI 1003693102
Family organization in Hagerstown, Maryland. Organization record, active in the CMS NPPES registry since September 12, 2023.
## Identity
- **NPI:** 1003693102 (Entity type: Organization)
- **Enumerated:** September 12, 2023
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Mark Roncone, OWNER/PROVIDER
## Practice location
- **Address:** 221 E BALTIMORE ST, Hagerstown, MD 21740-6109
- **Phone:** (240) 203-8864
## Record status
- **NPPES last updated:** September 12, 2023
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1003693102) · Data from the CMS NPPES public registry.