NPIMap

Organization Active NPI

Heritage Treatment Center Inc

  • Addiction Medicine (Internal Medicine) Physician
  • Baltimore, MD
National Provider Identifier
1568058196
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
Legal business name
HERITAGE TREATMENT CENTER INC
Practice address
4200 Edmondson Ave Ste 102
Baltimore, MD 21229-1600
Phone
(443) 224-0655
NPI assigned
Dec 17, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Authorized official

Name
Tiffany Lynnell BeaneNPI 1538574983
Title
Co-Owner
Phone
(443) 873-9389

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RA0401X Primary

Addresses

Primary practice location

4200 Edmondson Ave Ste 102
Baltimore, MD 21229-1600

Mailing address

4200 Edmondson Ave Ste 102
Baltimore, MD 21229-1600
Phone (443) 224-0655

Other names 3

  • HERITAGE TREATMENT CENTER Doing business as
  • HERITAGE TREATMENT CENTER INC Doing business as
  • HERITAGE TREATMENT CENTER LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Opioid treatment program
Medicare-enrolled since Jan 30, 2025

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250408001623 MD Part B Supplier - Opioid Treatment Program (Otp) 8628592987 Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory

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": "1608163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743724800000",
    "number": "1568058196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 EDMONDSON AVE STE 102",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212291600",
            "telephone_number": "443-224-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 EDMONDSON AVE STE 102",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212291600",
            "telephone_number": "443-224-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE TREATMENT CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-17",
        "last_updated": "2025-04-04",
        "certification_date": "2025-03-28",
        "status": "A",
        "authorized_official_last_name": "BEANE",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "LYNNELL",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "443-873-9389"
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HERITAGE TREATMENT CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HERITAGE TREATMENT CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HERITAGE TREATMENT CENTER INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HERITAGE TREATMENT CENTER LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.