MEDICAL PRACTICES OF ANTIETAM LLC
NPI 1629968086
Family Medicine in Hagerstown, MD

Active since July 08, 2025
17301 VALLEY MALL RD STE 125, HAGERSTOWN, MD 21740(301) 790-8000 Get Directions Write a Review

NPPES record last updated: July 8, 2025. Verified against the NPPES registry weekly; last sync: July 26, 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 1629968086) is a healthcare organization registered as a family medicine in Hagerstown, Maryland and active in the NPI registry since July 2025. The organization lists Joshua Repac, Cfo, as its authorized official.

NPPES Registry Identity

NPI1629968086
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMEDICAL PRACTICES OF ANTIETAM LLC
Location Address17301 VALLEY MALL RD STE 125Hagerstown, MD 21740-6966
Mailing Address17301 Valley Mall Rd Ste 125Hagerstown, MD 21740-6966
Organization SubpartNo
Authorized OfficialJoshua RepacCfo · (301) 790-9351
Enumeration DateJuly 8, 2025
NPPES CertifiedJuly 8, 2025
NPI 1629968086 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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.

17301 VALLEY MALL RD STE 125, Hagerstown, MD 21740

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 8

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

Clinic/Center
17301 VALLEY MALL RD STE 125
HAGERSTOWN, MD 21740
Physical Therapist
17301 VALLEY MALL RD STE 125
HAGERSTOWN, MD 21740
Internal Medicine (Sports Medicine)
17301 VALLEY MALL RD STE 125
HAGERSTOWN, MD 21740
Emergency Medicine (Sports Medicine)
17301 VALLEY MALL RD STE 125
HAGERSTOWN, MD 21740
Clinic/Center (Rehabilitation)
17301 VALLEY MALL RD STE 125
HAGERSTOWN, MD 21740
Clinic/Center
17301 VALLEY MALL RD STE 125
HAGERSTOWN, MD 21740
Physician Assistant
17301 VALLEY MALL RD STE 125
HAGERSTOWN, MD 21740
Clinic/Center (Urgent Care)
17301 VALLEY MALL RD STE 125
HAGERSTOWN, MD 21740

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 1629968086. It was assigned to this organization in the NPPES registry on July 8, 2025.

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) 790-8000.

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 July 8, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.