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MEDICAL PRACTICES OF ANTIETAM LLC
NPI 1710700042
Obstetrics & Gynecology - Gynecology in Hagerstown, MD

Active since November 05, 2024
11110 MEDICAL CAMPUS RD STE 147, HAGERSTOWN, MD 21742(301) 791-5555 Get Directions Write a Review

NPPES record last updated: March 10, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 10, 2026, Nov 5, 2024 (2 updates tracked since 2024).

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 1710700042) is a healthcare organization registered as a gynecology in Hagerstown, Maryland and active in the NPI registry since November 2024. The organization lists Joshua Repac, Cfo, as its authorized official.

NPPES Registry Identity

NPI1710700042
Entity TypeOrganization
Primary Taxonomy207VG0400X
Legal Business NameMEDICAL PRACTICES OF ANTIETAM LLC
Location Address11110 MEDICAL CAMPUS RD STE 147Hagerstown, MD 21742-6755
Mailing Address1130 Professional CtHagerstown, MD 21740-5852
Phone(301) 791-5555
Organization SubpartNo
Authorized OfficialJoshua RepacCfo · (301) 790-9351
Enumeration DateNovember 5, 2024
Last NPPES UpdateMarch 10, 20262 updates tracked since enumeration
NPPES CertifiedMarch 10, 2026
✔ NPI 1710700042 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207VG0400X
Definition
A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee
11110 MEDICAL CAMPUS RD STE 147, Hagerstown, MD 21742
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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

Other Providers at the Same Location NPPES 13

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

KIMBERLY ANNE OLCHEWSKY PA-C
Physician Assistant (Medical)
11110 MEDICAL CAMPUS RD STE 147
HAGERSTOWN, MD 21742
Washington County (301) 714-4350
MERITUS URGENT CARE LLC
Clinic/Center (Urgent Care)
11110 MEDICAL CAMPUS RD STE 147
HAGERSTOWN, MD 21742
Washington County (301) 790-8000
SARAH ELIZABETH BUCH PA-C
Physician Assistant
11110 MEDICAL CAMPUS RD STE 147
HAGERSTOWN, MD 21742
Washington County (301) 714-4350
MRS. STACEY NICOLE GIBSON CRNP
Nurse Practitioner (Family)
11110 MEDICAL CAMPUS RD STE 147
HAGERSTOWN, MD 21742
Washington County (301) 714-4350
KATHLEEN MAY WOODWARD P.A.-C
Physician Assistant
11110 MEDICAL CAMPUS RD STE 147
HAGERSTOWN, MD 21742
Washington County (301) 714-4350
MRS. HALEY MESOL PA-C
Physician Assistant
11110 MEDICAL CAMPUS RD STE 147
HAGERSTOWN, MD 21742
Washington County (301) 714-4350
XIN SEAN XIN D.O.
Neurological Surgery
11110 MEDICAL CAMPUS RD STE 147
HAGERSTOWN, MD 21742
Washington County (301) 790-8750
KIRTI VENKATESH PA-C
Physician Assistant
11110 MEDICAL CAMPUS RD STE 147
HAGERSTOWN, MD 21742
Washington County (301) 790-8750

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 1710700042. It was assigned to this organization in the NPPES registry on November 5, 2024.

Where is Medical Practices Of Antietam LLC located?

Medical Practices Of Antietam LLC is located at 11110 Medical Campus Rd Ste 147, Hagerstown, MD 21742. The listed phone number is (301) 791-5555.

What is Medical Practices Of Antietam LLC's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology, specializing in Gynecology, with taxonomy code 207VG0400X.

When was this NPI record last updated?

The NPPES record for Medical Practices Of Antietam LLC was last updated on March 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.