Provider Demographics
NPI:1053132886
Name:COMPREHENSIVE PRIMARY CARE AND ASSOCIATES, LLC
Entity type:Organization
Organization Name:COMPREHENSIVE PRIMARY CARE AND ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING PE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:IAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:LAMPKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:667-303-1042
Mailing Address - Street 1:15245 SHADY GROVE RD STE 340
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-7201
Mailing Address - Country:US
Mailing Address - Phone:301-869-9776
Mailing Address - Fax:301-417-4947
Practice Address - Street 1:9715 MEDICAL CENTER DR STE 510
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3320
Practice Address - Country:US
Practice Address - Phone:301-738-0300
Practice Address - Fax:301-738-1316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-23
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD420692406Medicaid