Active NPI
Cknmg
Doing business as Closeknit - PCP2
- Family Medicine Physician
- Baltimore, MD
National Provider Identifier
1902763162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- CKNMG
- Doing business as
- Closeknit - PCP2
- Practice address
- 1501 S Clinton St
Baltimore, MD 21224-5730 - Phone
- (866) 233-6925
- NPI assigned
- Jan 8, 2026
- 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
- Mary Jane Favazza
- Title
- Ceo
- Phone
- (410) 205-1487
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
1501 S Clinton St
Baltimore, MD 21224-5730
Mailing address
1501 S Clinton St
Baltimore, MD 21224-5730
Phone (866) 233-6925
Other names 1
- CLOSEKNIT - PCP2
National Provider Directory
National Provider Directory- Tax ID family
- Cknmg
Other organizations with this tax ID 5
Organizations that report the same tax identification number in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1767830400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1768867200000",
"number": "1902763162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 S CLINTON ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212245730",
"telephone_number": "866-233-6925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 S CLINTON ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212245730",
"telephone_number": "866-233-6925"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CKNMG",
"organizational_subpart": "NO",
"enumeration_date": "2026-01-08",
"last_updated": "2026-01-20",
"certification_date": "2026-01-20",
"status": "A",
"authorized_official_last_name": "FAVAZZA",
"authorized_official_first_name": "MARY",
"authorized_official_middle_name": "JANE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "410-205-1487"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "CLOSEKNIT - PCP2",
"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 Jan 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.