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ANTIETAM FAMILY HEALTH, LLC
NPI 1710793138
Nurse Practitioner - Family in Hagerstown, MD

Active since December 10, 2024
1219 MOUNT AETNA RD STE 201, HAGERSTOWN, MD 21742(240) 203-8864 Get Directions Write a Review

NPPES record last updated: February 24, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 9, 2025, Dec 10, 2024 (2 updates tracked since 2024).

About Antietam Family Health, Llc NPPES

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

ANTIETAM FAMILY HEALTH, LLC (NPI 1710793138) is a healthcare organization registered as a family in Hagerstown, Maryland and active in the NPI registry since December 2024. The organization lists Mark Anthony Roncone, Owner/provider, as its authorized official.

NPPES Registry Identity

NPI1710793138
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameANTIETAM FAMILY HEALTH, LLC
Location Address1219 MOUNT AETNA RD STE 201Hagerstown, MD 21742-6550
Mailing Address1219 Mount Aetna Rd Ste 201Hagerstown, MD 21742-6550 · (240) 203-8864 · Fax (240) 866-8173
Phone(240) 203-8864
Organization SubpartNo
Authorized OfficialMark Anthony RonconeOwner/provider · (240) 203-8864
Enumeration DateDecember 10, 2024
Last NPPES UpdateFebruary 24, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 24, 2026
✔ NPI 1710793138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X
1219 MOUNT AETNA RD STE 201, 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 3

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

ANTIETAM FAMILY HEALTH, LLC
Nurse Practitioner (Family)
1219 MOUNT AETNA RD STE 201
HAGERSTOWN, MD 21742
Washington County (240) 203-8864
ANTIETAM FAMILY HEALTH LLC
Nurse Practitioner (Family)
1219 MOUNT AETNA RD STE 201
HAGERSTOWN, MD 21742
Washington County (240) 203-8864
LORI A JENKINS CRNP, PMHNP
Nurse Practitioner (Psychiatric/Mental Health)
1219 MOUNT AETNA RD STE 201
HAGERSTOWN, MD 21742
Washington County (240) 203-8864

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 Antietam Family Health, LLC's NPI number?

The NPI number for Antietam Family Health, LLC is 1710793138. It was assigned to this organization in the NPPES registry on December 10, 2024.

Where is Antietam Family Health, LLC located?

Antietam Family Health, LLC is located at 1219 Mount Aetna Rd Ste 201, Hagerstown, MD 21742. The listed phone number is (240) 203-8864.

What is Antietam Family Health, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Antietam Family Health, LLC was last updated on February 24, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.