Healthcare Provider Details
I. General information
NPI: 1376203133
Provider Name (Legal Business Name): FIRSTCHOICE PRIMARY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/21/2021
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9715 MEDICAL CENTER DR STE 300
ROCKVILLE MD
20850-6309
US
IV. Provider business mailing address
9841 WASHINGTONIAN BLVD STE 200
GAITHERSBURG MD
20878-7350
US
V. Phone/Fax
- Phone: 240-720-7797
- Fax: 888-355-8829
- Phone: 240-720-7797
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133N00000X |
| Taxonomy | Nutritionist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QH0100X |
| Taxonomy | Health Service Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LG0600X |
| Taxonomy | Gerontology Nurse Practitioner |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP2300X |
| Taxonomy | Primary Care Nurse Practitioner |
| License Number | |
| License Number State | |
| # 10 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
AIRELLE
RUCKER-SMITH DNP, CRNP
Title or Position: MEDICAL DIRECTOR/PRACTICE OWNER
Credential: DNP, CRNP
Phone: 240-720-7797