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KHADEJA FAMILY PRACTICE, LLC
NPI 1255942231
Nurse Practitioner - Family in Frederick, MD

Active since August 12, 2020CLIA 21D2317297 · Waiver
5 HILLCREST DR STE B103, FREDERICK, MD 21703(571) 275-6765 Get Directions Write a Review

NPPES record last updated: April 4, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 4, 2024, Aug 12, 2020 (2 updates tracked since 2020).

About Khadeja Family Practice, Llc NPPES

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

KHADEJA FAMILY PRACTICE, LLC (NPI 1255942231) is a healthcare organization registered as a family in Frederick, Maryland and active in the NPI registry since August 2020. The organization holds a CLIA Waiver certificate valid through January 21, 2027 and lists Khadeja Baidoo, Np/ Manager, as its authorized official.

NPPES Registry Identity

NPI1255942231
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameKHADEJA FAMILY PRACTICE, LLC
Location Address5 HILLCREST DR STE B103Frederick, MD 21703-6115
Mailing Address4843 Marsden PlFrederick, MD 21703-6822 · (240) 439-5619 · Fax (240) 597-1196
Phone(571) 275-6765
Organization SubpartNo
Authorized OfficialKhadeja BaidooNp/ Manager · (571) 275-6765
Enumeration DateAugust 12, 2020
Last NPPES UpdateApril 4, 20242 updates tracked since enumeration
NPPES CertifiedApril 4, 2024
✔ NPI 1255942231 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
5 HILLCREST DR STE B103, Frederick, MD 21703
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Other Names 1

Doing Business AsKhadeja Family Practice, Llc

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 21D2317297

Khadeja Family Practice LLC · Frederick, MD
Active · expires Jan 21, 2027
CLIA Number21D2317297
Laboratory TypePhysician Office
Certificate Effective DateJanuary 22, 2025
Certificate Expiration DateJanuary 21, 2027
Laboratory DirectorKhadeja Q. Baidoo
Laboratory Phone(240) 439-5619
Laboratory LocationKhadeja Family Practice LLC5 Hillcrest Dr #b103, Frederick, MD 21703
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Khadeja Family Practice, LLC's NPI number?

The NPI number for Khadeja Family Practice, LLC is 1255942231. It was assigned to this organization in the NPPES registry on August 12, 2020.

Where is Khadeja Family Practice, LLC located?

Khadeja Family Practice, LLC is located at 5 Hillcrest Dr Ste B103, Frederick, MD 21703. The listed phone number is (571) 275-6765.

What is Khadeja Family Practice, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Khadeja Family Practice, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2317297) is associated with this NPI, valid through January 21, 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 Khadeja Family Practice, LLC was last updated on April 4, 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.