NPIMap

Organization Active NPI

Charm City Medical Intensive Outpatient Program

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baltimore, MD
National Provider Identifier
1619706462
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CHARM CITY MEDICAL INTENSIVE OUTPATIENT PROGRAM
Practice address
2220 Reisterstown Rd
Baltimore, MD 21217-1928
Phone
(301) 675-1296
Fax
(443) 535-0773
NPI assigned
Jul 30, 2024
Organization subpart
Yes
Parent organization
CHARM CITY MEDICAL CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 18, 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
Title
Chief Medical Officer
Phone
(301) 646-3279

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

2220 Reisterstown Rd
Baltimore, MD 21217-1928

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
Charm City Outpatient Treatment Level 18 organizations share this tax ID, including this one
Part of
Charm City Outpatient Treatment Level 1

Other organizations with this tax ID 7

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

Locations

2220 Reisterstown Rd
Ste 2240
Baltimore, MD 21217

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1619706462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6041 WINTER GRAIN PATH",
            "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 MEDICAL INTENSIVE OUTPATIENT PROGRAM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHARM CITY MEDICAL CENTER, INC.",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "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",
        "authorized_official_telephone_number": "301-646-3279",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Sep 18, 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.