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MEDICAL PRACTICES OF ANTIETAM LLC
NPI 1669271086
General Practice in Hagerstown, MD

Active since March 10, 2025
19800 TRANQUILITY CIR, HAGERSTOWN, MD 21742(301) 790-8000 Get Directions Write a Review

NPPES record last updated: March 10, 2025. Verified against the NPPES registry weekly; last sync: August 02, 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 1669271086) is a healthcare organization registered as a general practice in Hagerstown, Maryland and active in the NPI registry since March 2025. The organization lists Joshua Repac, Cfo, as its authorized official.

NPPES Registry Identity

NPI1669271086
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameMEDICAL PRACTICES OF ANTIETAM LLC
Location Address19800 TRANQUILITY CIRHagerstown, MD 21742-4042
Mailing Address11116 Medical Campus RdHagerstown, MD 21742-6710
Phone(301) 790-8000
Organization SubpartNo
Authorized OfficialJoshua RepacCfo · (301) 790-9351
Enumeration DateMarch 10, 2025
NPPES CertifiedMarch 10, 2025
✔ NPI 1669271086 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
19800 TRANQUILITY CIR, Hagerstown, MD 21742
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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 5

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

DIAKON LUTHERAN SENIOR LIVING - MARYLAND LLC
Assisted Living Facility
19800 TRANQUILITY CIR
HAGERSTOWN, MD 21742
Washington County (240) 420-4100
CALLA ASHLEY LOADMAN
Speech-Language Pathologist
19800 TRANQUILITY CIR
HAGERSTOWN, MD 21742
Washington County (240) 420-4340
MRS. HOLLY ANN PECK PTA
Physical Therapy Assistant
19800 TRANQUILITY CIR
HAGERSTOWN, MD 21742
Washington County (717) 658-1597
MISS STEPHANIE KAY COOKE SLP
Speech-Language Pathologist
19800 TRANQUILITY CIR
HAGERSTOWN, MD 21742
Washington County (240) 329-4340
DIAKON LUTHERAN SENIOR LIVING-MARYLAND RAVENWOOD CAMPUS
Nursing Facility/Intermediate Care Facility
19800 TRANQUILITY CIR
HAGERSTOWN, MD 21742
Washington County (301) 790-1000

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 1669271086. It was assigned to this organization in the NPPES registry on March 10, 2025.

Where is Medical Practices Of Antietam LLC located?

Medical Practices Of Antietam LLC is located at 19800 Tranquility Cir, Hagerstown, MD 21742. 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 General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Medical Practices Of Antietam LLC was last updated on March 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.