NPIMap

Organization Active NPI

Innovative Treatment Centers

  • Addiction Medicine (Family Medicine) Physician
  • Glen Burnie, MD
National Provider Identifier
1730892035
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
INNOVATIVE TREATMENT CENTERS
Practice address
325 Hospital Dr Ste 106
Glen Burnie, MD 21061-5806
Phone
(917) 873-5716
NPI assigned
Jan 2, 2023
Last updated
May 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Authorized official

Name
Travis A Baird, NPNPI 1235548314
Title
Owner
Phone
(443) 430-2998

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X Primary
Adult Health Nurse Practitioner 363LA2200X

Addresses

Primary practice location

325 Hospital Dr Ste 106
Glen Burnie, MD 21061-5806

Mailing address

325 Hospital Dr Ste 106
Glen Burnie, MD 21061-5806
Phone (917) 873-5716

Other identifiers 1

IdentifierTypeStateIssuer
699298601MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230225000056 MD Part B Supplier - Clinic/Group Practice 1052784840 Receives reassigned benefits from 8 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Glen Burnie, MD; Frederick, MD

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Innovative Treatment Centers LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 8

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": "1672617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1730892035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 HOSPITAL DR STE 106",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615806",
            "telephone_number": "917-873-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 HOSPITAL DR STE 106",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615806",
            "telephone_number": "917-873-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE TREATMENT CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-02",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-19",
        "status": "A",
        "authorized_official_last_name": "BAIRD",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-430-2998",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "699298601",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.