Healthcare Provider Details

I. General information

NPI: 1659269306
Provider Name (Legal Business Name): COMPREHENSIVE PRIMARY CARE AND ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6230 CENTRAL AVE UNIT 6
SEAT PLEASANT MD
20743-6128
US

IV. Provider business mailing address

15245 SHADY GROVE RD STE 340
ROCKVILLE MD
20850-7201
US

V. Phone/Fax

Practice location:
  • Phone: 301-869-9766
  • Fax: 301-417-4947
Mailing address:
  • Phone: 667-303-1042
  • Fax: 301-417-4947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: IAN C LAMPKIN
Title or Position: CREDENTIALING PE SPECIALIST
Credential:
Phone: 667-303-1042