NPIMap

Organization Active NPI

Medication Assisted Treatment Technologies, Inc

  • Methadone Clinic
  • Belcamp, MD
National Provider Identifier
1295724656
Registry record updated Dec 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
License
12234 Issued in MD
Legal business name
MEDICATION ASSISTED TREATMENT TECHNOLOGIES, INC
Practice address
1361 Brass Mill Road
BLDG. a
Belcamp, MD 21017-1213
Phone
(410) 273-9700
Fax
(410) 273-9713
NPI assigned
Oct 18, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2010

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

Authorized official

Name
Mr. J. Charles Smith Jr.
Title
C.E.O., Sponsor
Phone
(410) 322-6575

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 101202 MD
Methadone Clinic 261QM2800X 101202 MD
Methadone Clinic 261QM2800X 12234 MD Primary

Addresses

Primary practice location

1361 Brass Mill Road
BLDG. a
Belcamp, MD 21017-1213

Mailing address

1361 Brass Mill Road
BLDG. a
Belcamp, MD 21017-1213
Phone (410) 273-9700

Other identifiers 3

IdentifierTypeStateIssuer
0019661780001MedicaidPA
4034538-00MedicaidMD
403453800MedicaidMD

Other names 1

  • matt program Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Matt Program2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1361 Brass Mill Rd
Ste A
Belcamp, MD 21017
Phone (410) 273-9700

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291161600000",
    "number": "1295724656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 BRASS MILL ROAD",
            "address_2": "BLDG. A",
            "city": "BELCAMP",
            "state": "MD",
            "postal_code": "210171213",
            "telephone_number": "410-273-9700",
            "fax_number": "410-273-9713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 BRASS MILL ROAD",
            "address_2": "BLDG. A",
            "city": "BELCAMP",
            "state": "MD",
            "postal_code": "210171213",
            "telephone_number": "410-273-9700",
            "fax_number": "410-273-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICATION ASSISTED TREATMENT TECHNOLOGIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-18",
        "last_updated": "2010-12-01",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "J.",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "C.E.O., SPONSOR",
        "authorized_official_telephone_number": "410-322-6575",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "101202",
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "MD",
            "license": "101202",
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "MD",
            "license": "12234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019661780001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4034538-00",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "403453800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "matt program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Belcamp, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; 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.