Active NPI
Innovative Urgent Care, LLC
- Urgent Care Clinic/Center
- Damascus, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urgent Care Clinic/Center
- Legal business name
- INNOVATIVE URGENT CARE, LLC
- Practice address
- 9809 Main St Ste 103
Damascus, MD 20872-2090 - Phone
- (443) 512-8337
- NPI assigned
- Jun 20, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Esteban Schableman, MD
- Title
- President
- Phone
- (267) 258-6362
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Primary |
Addresses
Primary practice location
9809 Main St Ste 103
Damascus, MD 20872-2090
Mailing address
12815 Macbeth Farm LN
Clarksville, MD 21029-1556
Phone (267) 258-6362
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, MD
Enrollment records 2
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 21D2304090 | Innovative Urgent Care | Certificate of waiver | May 6, 2028 |
National Provider Directory
National Provider DirectoryLocations
22750 Newcut Rd
Ste D1B
Clarksburg, MD 20871
Phone (301) 302-8513
9815 Main St
Ste 103
Damascus, MD 20872
Practitioners & affiliated clinicians
Practitioners 15
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": "1687219200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1724371200000",
"number": "1821773508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12815 MACBETH FARM LN",
"city": "CLARKSVILLE",
"state": "MD",
"postal_code": "210291556",
"telephone_number": "267-258-6362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9809 MAIN ST STE 103",
"city": "DAMASCUS",
"state": "MD",
"postal_code": "208722090",
"telephone_number": "443-512-8337"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INNOVATIVE URGENT CARE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-06-20",
"last_updated": "2024-08-23",
"certification_date": "2024-08-23",
"status": "A",
"authorized_official_last_name": "SCHABLEMAN",
"authorized_official_first_name": "ESTEBAN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "267-258-6362",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Damascus, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.