NPIMap

Organization Active NPI

Charm City Primary Care, LLC

  • Primary Care Clinic/Center
  • Baltimore, MD
National Provider Identifier
1114321767
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CHARM CITY PRIMARY CARE, LLC
Practice address
2220 Reisterstown Rd
Baltimore, MD 21217-1928
Phone
(301) 675-1296
Fax
(443) 535-0773
NPI assigned
Oct 10, 2014
Last updated
Jun 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Devesh Dhruva Kanjarpane, MD MPH FACPM FACOEMNPI 1548418726
Title
Chief Medical Officer (Cmo)
Phone
(301) 675-1296

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X NU
Health Service Clinic/Center 261QH0100X NU
Primary Care Clinic/Center 261QP2300X NU Primary
Preventive Medicine/Occupational Environmental Medicine Physician 2083P0500X D0040076 MD

Addresses

Primary practice location

2220 Reisterstown Rd
Baltimore, MD 21217-1928

Mailing address

6041 Winter Grain Path
Ste #1F
Clarksville, MD 21029-1224
Phone (301) 675-1296

National Provider Directory

National Provider Directory

Locations

2220 Reisterstown Rd
Ste 1
Baltimore, MD 21217
Phone (301) 675-1296

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1114321767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6041 WINTER GRAIN PATH",
            "address_2": "STE #1F",
            "city": "CLARKSVILLE",
            "state": "MD",
            "postal_code": "210291224",
            "telephone_number": "301-675-1296",
            "fax_number": "443-535-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 REISTERSTOWN RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212171928",
            "telephone_number": "301-675-1296",
            "fax_number": "443-535-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARM CITY PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-10",
        "last_updated": "2024-06-13",
        "certification_date": "2024-02-08",
        "status": "A",
        "authorized_official_last_name": "KANJARPANE",
        "authorized_official_first_name": "DEVESH",
        "authorized_official_middle_name": "DHRUVA",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER (CMO)",
        "authorized_official_telephone_number": "301-675-1296",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD MPH FACPM FACOEM"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "MD",
            "license": "D0040076",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.