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MEDICAL PRACTICES OF ANTIETAM LLC
NPI 1508664145
Family Medicine in Smithsburg, MD

Active since March 07, 2025
22911 JEFFERSON BLVD, SMITHSBURG, MD 21783(301) 824-3343 Get Directions Write a Review

NPPES record last updated: March 7, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Medical Practices Of Antietam Llc NPPES

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

MEDICAL PRACTICES OF ANTIETAM LLC (NPI 1508664145) is a healthcare organization registered as a family medicine in Smithsburg, Maryland and active in the NPI registry since March 2025. The organization lists Joshua Repac, Cfo, as its authorized official.

NPPES Registry Identity

NPI1508664145
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMEDICAL PRACTICES OF ANTIETAM LLC
Location Address22911 JEFFERSON BLVDSmithsburg, MD 21783-1617
Mailing Address11116 Medical Campus RdHagerstown, MD 21742-6710
Phone(301) 824-3343
Organization SubpartNo
Authorized OfficialJoshua RepacCfo · (301) 790-9351
Enumeration DateMarch 7, 2025
NPPES CertifiedMarch 7, 2025
✔ NPI 1508664145 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedGeneral PracticeTaxonomy 208D00000X
22911 JEFFERSON BLVD, Smithsburg, MD 21783
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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

Other Providers at the Same Location NPPES 12

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

BRADLEY INGRAM PAC
Physician Assistant (Medical)
22911 JEFFERSON BLVD
SMITHSBURG, MD 21783
Washington County (301) 824-3343
TAYLOR B JAMES
Physician Assistant
22911 JEFFERSON BLVD
SMITHSBURG, MD 21783
Washington County (301) 824-3343
DR. WILLIAM B KERNS M.D.
Pediatrics
22911 JEFFERSON BLVD
SMITHSBURG, MD 21783
Washington County (301) 824-3343
DR. BRIAN K. BONHAM M.D.
Pediatrics
22911 JEFFERSON BLVD
SMITHSBURG, MD 21783
Washington County (301) 824-3343
JENNIFER LYNN NUNNELEE PA
Physician Assistant
22911 JEFFERSON BLVD
SMITHSBURG, MD 21783
Washington County (301) 824-3343
DR. DIPTI MOHANLAL MISTRY MD
Internal Medicine
22911 JEFFERSON BLVD
SMITHSBURG, MD 21783
Washington County (301) 824-3343
SUSANNA M. GOHEEN M.D.
Internal Medicine
22911 JEFFERSON BLVD
SMITHSBURG, MD 21783
Washington County (301) 824-3343
JASMINE KAUR GULATI DO
Family Medicine
22911 JEFFERSON BLVD
SMITHSBURG, MD 21783
Washington County (301) 824-3343

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 1508664145. It was assigned to this organization in the NPPES registry on March 7, 2025.

Where is Medical Practices Of Antietam LLC located?

Medical Practices Of Antietam LLC is located at 22911 Jefferson Blvd, Smithsburg, MD 21783. The listed phone number is (301) 824-3343.

What is Medical Practices Of Antietam LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Medical Practices Of Antietam LLC was last updated on March 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.