Healthcare Provider Details

I. General information

NPI: 1427879253
Provider Name (Legal Business Name): COMPREHENSIVE PRIMARY CARE AND ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8455 COLESVILLE RD STE 1125
SILVER SPRING MD
20910-6397
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 301-869-9776
  • Fax:
Mailing address:
  • Phone: 301-869-9776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
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

VIII. Authorized Official

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