ANTIETAM FAMILY HEALTH, LLC
NPI 1548972318
Nurse Practitioner - Family in Hagerstown, MD
NPI Status: Active since December 23, 2022
Contact Information
1219 MOUNT AETNA RD STE 201
HAGERSTOWN, MD
ZIP 21742
Phone: (240) 203-8864
Fax: (240) 866-8173
- Organization
- Nurse Practitioner
- Family
- CLIA Number: 21D2283320
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 06-05-2027
About ANTIETAM FAMILY HEALTH, LLC
This page provides the complete NPI Profile along with additional information for Antietam Family Health, Llc, a provider established in Hagerstown, Maryland operating as a Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1548972318 assigned on December 2022. The practitioner's primary taxonomy code is 363LF0000X. The provider is registered as an organization and their NPI record was last updated February 2026. Antietam Family Health, Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mark Anthony Roncone Fnp (Owner)
- NPI
- 1548972318
- Provider Name
- ANTIETAM FAMILY HEALTH, LLC
- Entity Type
- Organization
- Location Address
- 1219 MOUNT AETNA RD STE 201 HAGERSTOWN, MD 21742
- Location Phone
- (240) 203-8864
- Location Fax
- (240) 866-8173
- Mailing Address
- 1219 MOUNT AETNA RD STE 201 HAGERSTOWN, MD 21742
- Mailing Phone
- (240) 203-8864
- Mailing Fax
- (240) 866-8173
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-23-2022
- Last Update Date
- 02-24-2026
- Code Navigator
A nurse practitioner (NP) like Antietam Family Health, Llc is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Secondary Locations
- 330 Frederick St
Hagerstown, MD 21740
(240) 203-8864 - 427 E Patrick St
Frederick, MD 21701
(240) 203-8864
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner Family
- Taxonomy Code
- 363LF0000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 101YP2500X | Behavioral Health & Social Service Providers | Counselor | |
| 2 | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 319064100 | MEDICAID (05) | MD | |
| 287005300 | MEDICAID (05) | MD |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 21D2283320
- Facility Type
- Physician Office
- Certificate Effective Date
- June 06, 2025
- Certificate Expiration Date
- June 05, 2027
- Laboratory Director
- MARK A. RONCONE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Antietam Family Health, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for ANTIETAM FAMILY HEALTH, LLC
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1548972318, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 72. The final step is to find the difference between that total and the next multiple of ten (80 - 72 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 72 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
HAGERSTOWN, MD 21742
HAGERSTOWN, MD 21742
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1548972318, enumerated as an "organization" on December 23, 2022.
The provider is located at 1219 MOUNT AETNA RD STE 201 HAGERSTOWN, MD 21742 and the phone number is (240) 203-8864.
Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
