1. Home
  2. Directory
  3. Maryland
  4. Hagerstown
  5. Internal Medicine
  6. NPI Profile

MERITUS SPORTS MEDICINE
NPI 1184481459
Internal Medicine - Sports Medicine in Hagerstown, MD

Active since March 04, 2024CLIA 21D2307114 · Waiver
17301 VALLEY MALL RD STE 125, HAGERSTOWN, MD 21740(301) 790-9237 Get Directions Write a Review

NPPES record last updated: March 5, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Meritus Sports Medicine NPPES

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

MERITUS SPORTS MEDICINE (NPI 1184481459) is a healthcare organization registered as a sports medicine in Hagerstown, Maryland and active in the NPI registry since March 2024. The organization holds a CLIA Waiver certificate valid through July 1, 2028 and lists Joshua Repac, Cfo, as its authorized official.

NPPES Registry Identity

NPI1184481459
Entity TypeOrganization
Primary Taxonomy207RS0010X
Legal Business NameMEDICAL PRACTICES OF ANTIETAM LLC
Location Address17301 VALLEY MALL RD STE 125Hagerstown, MD 21740-6966
Mailing Address11116 Medical Campus RdHagerstown, MD 21742-6710
Phone(301) 790-9237
Organization SubpartNo
Authorized OfficialJoshua RepacCfo · (301) 790-9351
Enumeration DateMarch 4, 2024
Last NPPES UpdateMarch 5, 2024
NPPES CertifiedMarch 5, 2024
✔ NPI 1184481459 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RS0010X
Definition
An internist trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual.
17301 VALLEY MALL RD STE 125, Hagerstown, MD 21740
Open in Google Maps ↗

Other Names 1

Doing Business AsMeritus Sports Medicine

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

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 21D2307114

Meritus Sports Medicine - Valley Mall · Hagerstown, MD
Active · expires Jul 1, 2028
CLIA Number21D2307114
Laboratory TypePhysician Office
Certificate Effective DateJuly 2, 2026
Certificate Expiration DateJuly 1, 2028
Laboratory DirectorDr. Geoffrey N. Sanyi
Laboratory Phone(301) 714-4400
Laboratory LocationMeritus Sports Medicine - Valley Mall17301 Valley Mall Rd #125, Hagerstown, MD 21740
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

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

MERITUS URGENT CARE, LLC
Clinic/Center
17301 VALLEY MALL RD STE 125
HAGERSTOWN, MD 21740
Washington County (301) 790-9239
ZYON EMANUEL WILEY
Physical Therapist
17301 VALLEY MALL RD STE 125
HAGERSTOWN, MD 21740
Washington County (301) 790-9238
MEDICAL PRACTICES OF ANTIETAM LLC
Emergency Medicine (Sports Medicine)
17301 VALLEY MALL RD STE 125
HAGERSTOWN, MD 21740
Washington County (301) 790-9237
MERITUS MEDICAL CENTER INC
Clinic/Center (Rehabilitation)
17301 VALLEY MALL RD STE 125
HAGERSTOWN, MD 21740
Washington County (301) 714-4025
MERITUS URGENT CARE LLC
Clinic/Center
17301 VALLEY MALL RD STE 125
HAGERSTOWN, MD 21740
Washington County (301) 302-7837
MEDICAL PRACTICES OF ANTIETAM LLC
Family Medicine
17301 VALLEY MALL RD STE 125
HAGERSTOWN, MD 21740
Washington County (301) 790-8000
ETHAN MARSHALL BULGER
Physician Assistant
17301 VALLEY MALL RD STE 125
HAGERSTOWN, MD 21740
Washington County (301) 790-9236
MERITUS URGENT CARE LLC
Clinic/Center (Urgent Care)
17301 VALLEY MALL RD STE 125
HAGERSTOWN, MD 21740
Washington County (240) 313-3100

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 Medical Practices Of Antietam LLC's NPI number?

The NPI number for Medical Practices Of Antietam LLC is 1184481459. It was assigned to this organization in the NPPES registry on March 4, 2024. The provider is doing business as Meritus Sports Medicine.

Where is Medical Practices Of Antietam LLC located?

Medical Practices Of Antietam LLC is located at 17301 Valley Mall Rd Ste 125, Hagerstown, MD 21740. The listed phone number is (301) 790-9237.

What is Medical Practices Of Antietam LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Sports Medicine, with taxonomy code 207RS0010X.

Does Medical Practices Of Antietam LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2307114) is associated with this NPI, valid through July 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Medical Practices Of Antietam LLC was last updated on March 5, 2024. 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.