MEDICARE: COMMUNITY CONCIERGE CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1689311508
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY CONCIERGE CARE LLC

Provider Business Mailing Address
First Line	:	1231 MARION BARRY AVE SE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-6907
Country	:	US
Telephone Number	:	202-600-1257
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 DELAWARE AVE SW APT 3
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20024-3900
Country	:	US
Telephone Number	:	202-888-6440
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ERIN ATHEY
Credential	:
Telephone Number	:	703-593-9103

Provider Enumeration Date	:	05/13/2022
Last Update Date	:	01/20/2025

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Directions to “COMMUNITY CONCIERGE CARE LLC ” Practice Location

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