| Antietam Family Health, LLC | |
|
1219 Mount Aetna Rd Ste 201 Hagerstown MD 21742-6550 | |
| (240) 203-8864 | |
| (240) 866-8173 |
| Full Name | Antietam Family Health, LLC |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1219 Mount Aetna Rd Ste 201, Hagerstown, Maryland |
| Authorized Official Name and Position | Mark Anthony Roncone (OWNER) |
| Authorized Official Contact | 2402038864 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Antietam Family Health, LLC 1219 Mount Aetna Rd Ste 201 Hagerstown MD 21742-6550 Ph: (240) 203-8864 | Antietam Family Health, LLC 1219 Mount Aetna Rd Ste 201 Hagerstown MD 21742-6550 Ph: (240) 203-8864 |
| NPI Number | 1548972318 |
|---|---|
| Provider Enumeration Date | 12/23/2022 |
| Last Update Date | 02/24/2026 |
| Certification Date | 02/24/2026 |
| Medicare PECOS PAC ID | 6406228246 |
|---|---|
| Medicare Enrollment ID | O20230204000014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548972318 | NPI | - | NPPES |
| 319064100 | Medicaid | MD | |
| 287005300 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | () | Secondary |
| 363LF0000X | Nurse Practitioner - Family | () | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | () | Secondary |
| Provider Name | Mark Anthony Roncone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669982872 PECOS PAC ID: 4789942301 Enrollment ID: I20180103000027 |
| Provider Name | Meghan E Mann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578920617 PECOS PAC ID: 5597026054 Enrollment ID: I20180223001457 |
| Provider Name | Lori Jenkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154891000 PECOS PAC ID: 0446599526 Enrollment ID: I20190307001463 |
| Provider Name | Jessica Lloyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770136566 PECOS PAC ID: 5496185951 Enrollment ID: I20201110000034 |
| Provider Name | Allison Joy Beall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518664622 PECOS PAC ID: 3870968506 Enrollment ID: I20230412000711 |
| Provider Name | Danielle Roncone |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154521896 PECOS PAC ID: 9436510096 Enrollment ID: I20240124000713 |
| Provider Name | Ashley Bechtel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215771720 PECOS PAC ID: 3779015144 Enrollment ID: I20250306003656 |
| Provider Name | Jennifer Mostowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588559413 PECOS PAC ID: 5395232045 Enrollment ID: I20251015004190 |
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