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FREDERICK HEALTH MEDICAL GROUP LLC
NPI 1043102205
Dietitian, Registered in Frederick, MD

Active since July 21, 2025CLIA Certified · 3 labs
1562 OPOSSUMTOWN PIKE, FREDERICK, MD 21702(240) 215-6310 Get Directions Write a Review

NPPES record last updated: July 21, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Frederick Health Medical Group Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FREDERICK HEALTH MEDICAL GROUP LLC (NPI 1043102205), doing business as Frederick Health Medical Group, is a healthcare organization registered as a dietitian, registered in Frederick, Maryland and active in the NPI registry since July 2025. The organization holds 3 active CLIA laboratory certificates and lists Shelby Boggs, Avp, as its authorized official.

NPPES Registry Identity

NPI1043102205
Entity TypeOrganization
Primary Taxonomy133V00000X
Legal Business NameFREDERICK HEALTH MEDICAL GROUP LLC
Location Address1562 OPOSSUMTOWN PIKEFrederick, MD 21702-4920
Mailing Address1 Frederick Health WayFrederick, MD 21701-9435
Phone(240) 215-6310
Organization SubpartNo
Authorized OfficialShelby BoggsAvp · (240) 315-3423
Enumeration DateJuly 21, 2025
NPPES CertifiedJuly 21, 2025
✔ NPI 1043102205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
1562 OPOSSUMTOWN PIKE, Frederick, MD 21702
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Other Names 1

Doing Business AsFrederick Health Medical Group

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 3

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 for Provider-Performed Microscopy Procedures (PPMP) 21D2040584

Frederick Health Medical Group · Frederick, MD
Active · expires May 3, 2028
CLIA Number21D2040584
Laboratory TypePhysician Office
Certificate Effective DateMay 4, 2026
Certificate Expiration DateMay 3, 2028
Laboratory DirectorAlice Esame
Laboratory Phone(240) 215-6310
Laboratory LocationFrederick Health Medical Group7211 Bank Ct #230, Frederick, MD 21703
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 21D0715404

Frederick Health Medical Group · Frederick, MD
Active · expires Jul 7, 2027
CLIA Number21D0715404
Laboratory TypePhysician Office
Certificate Effective DateJuly 8, 2025
Certificate Expiration DateJuly 7, 2027
Laboratory DirectorDr. Margaret P. Oberman
Laboratory Phone(240) 215-6310
Laboratory LocationFrederick Health Medical Group501 West 7th St Suite 104, Frederick, MD 21701
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 21D0951628

Frederick Health Medical Group · Mount Airy, MD
Active · expires Mar 31, 2027
CLIA Number21D0951628
Laboratory TypePhysician Office
Certificate Effective DateApril 1, 2025
Certificate Expiration DateMarch 31, 2027
Laboratory DirectorDr. Alice Esame
Laboratory Phone(240) 215-6310
Laboratory LocationFrederick Health Medical Group504 E Ridgeville Boulevard Suite 120, Mount Airy, MD 21771
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. JEANETTE E FORONDA P.A.
Physician Assistant
1562 OPOSSUMTOWN PIKE
FREDERICK, MD 21702
Frederick County (240) 215-6310
INGRID HALVORSON
Nurse Practitioner (Acute Care)
1562 OPOSSUMTOWN PIKE
FREDERICK, MD 21702
Frederick County (301) 662-8477
DR. PATRICK JOHANNES MANSKY M.D.
Internal Medicine (Medical Oncology)
1562 OPOSSUMTOWN PIKE
FREDERICK, MD 21702
Frederick County (301) 662-8477
MS. PATRICIA A. RICE CRNP
Nurse Practitioner (Adult Health)
1562 OPOSSUMTOWN PIKE
FREDERICK, MD 21702
Frederick County (301) 662-8477
CAROLYN SHERWOOD PT
Physical Therapist
1562 OPOSSUMTOWN PIKE
FREDERICK, MD 21702
Frederick County (240) 566-3400
LENY VANESSA BERNARDO-POLLOCK PA-C
Physician Assistant
1562 OPOSSUMTOWN PIKE
FREDERICK, MD 21702
Frederick County (240) 215-6310
MISS CLAUDIA OFORI-MARFOH MD
Urology
1562 OPOSSUMTOWN PIKE
FREDERICK, MD 21702
Frederick County (240) 215-6310
DEBRA PATON OT
Occupational Therapist
1562 OPOSSUMTOWN PIKE
FREDERICK, MD 21702
Frederick County (240) 566-3400

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 Frederick Health Medical Group LLC's NPI number?

The NPI number for Frederick Health Medical Group LLC is 1043102205. It was assigned to this organization in the NPPES registry on July 21, 2025. The provider is doing business as Frederick Health Medical Group.

Where is Frederick Health Medical Group LLC located?

Frederick Health Medical Group LLC is located at 1562 Opossumtown Pike, Frederick, MD 21702. The listed phone number is (240) 215-6310.

What is Frederick Health Medical Group LLC's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Does Frederick Health Medical Group LLC hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Frederick Health Medical Group LLC was last updated on July 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.