BALTIMORE KETAMINE CLINIC (NPI# 1972145381) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972145381 |
| Entity Type | Organization |
| Organization Name | BALTIMORE KETAMINE CLINIC |
| Practice Address |
1 Texas Station Ct Ste 320 Timonium MD 21093-8290 |
| Practice Telephone | 4108705482 |
| Practice Fax Number | 4106281212 |
| Mailing Telephone | 4108705482 |
| Mailing Fax Number | 4106281212 |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2019-10-17 |
| Authorized Official Name | IVANA MITIC (GROUP OWNER) |
| Authorized Official Telephone | 7134123462 |
| Authorized Official Credential | CRNA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QI0500X |
Clinic/Center Specialization: Infusion Therapy |
Ambulatory Health Care Facilities |
| Street Address |
1 TEXAS STATION CT STE 320 |
| City | TIMONIUM |
| State | MD |
| Zip Code | 21093-8290 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497309959 | Megan Lagergren | Social Worker | 1407 York Rd. Suite 307, Baltimore, MD 21093 | 2019-08-01 |
| 1437629003 | Mary Ann Lopus | Counselor | Villa Maria School 2300 Dulaney Valley Road, Timonium, MD 21093 | 2018-11-27 |
| 1275001455 | Hannah Michele Breckenridge | Social Worker | 1212 York Rd Ste A302, Lutherville, MD 21093 | 2018-11-06 |
| 1386111573 | Christina Calabrese | Social Worker | Villa Maria School, 2300 Dulaney Valley Road, Timonium, MD 21093 | 2018-10-26 |
| 1790279735 | Synopsis Healthscience | Internal Medicine | 19 Huntress Ct, Timonium, MD 21093 | 2018-06-21 |
| 1134648629 | Centers for Advanced Orthopaedics, LLC | Occupational Therapist | 1312 Bellona Ave Ste 302, Lutherville, MD 21093 | 2017-09-15 |
| 1134647746 | Andrea Stokes Rackowski | Social Worker | 1400 Front Ave. Suite 305, Lutherville, MD 21093 | 2017-09-03 |
| 1790200780 | Judson Franklin Force Jr. | Pediatrics | 309 Overlook Dr, Timonium, MD 21093 | 2017-08-10 |
| 1942722053 | Eundae Suk | Chiropractor | 1407 York Rd Ste 302, Lutherville, MD 21093 | 2017-07-10 |
| 1508301482 | Bh Brightview Mays Chapel Ridge Opco, LLC | Alzheimer Center (Dementia Center) | 12261 Roundwood Road, Timonium, MD 21093 | 2016-12-30 |
| Find all providers in zip 21093 | ||||
| Taxonomy Code | 261QI0500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Infusion Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265917017 | Hagerstown Infusion, LLC | Clinic/Center | 1829 Howell Rd Ste 2b, Hagerstown, MD 21740-6606 | 2018-09-27 |
| 1336629609 | Rhenew Infusion Services LLC | Clinic/Center | 166 Defense Hwy Ste L102, Annapolis, MD 21401-8925 | 2018-08-16 |
| 1740771179 | Advanced Practitioner Healthcare Networking, LLC | Clinic/Center | 6246 Montrose Rd, North Bethesda, MD 20852 | 2018-05-22 |
| 1740783752 | Jean Walter Infusion Center, LLC | Clinic/Center | 700 Geipe Road St. 100, Catonsville, MD 21228 | 2018-03-15 |
| 1881104065 | Ally Infusion, LLC | Clinic/Center | 7651 Matapeake Bus Dr Ste 103, Brandywine, MD 20613 | 2017-10-02 |
| 1922537299 | Medvenous LLC | Clinic/Center | 4200 Forbes Blvd Ste 209, Lanham, MD 20706-4829 | 2017-06-08 |
| 1568400687 | Option Care Enterprises, Inc. | Clinic/Center | 9140 Guilford Rd, Suite K, Columbia, MD 21046-1811 | 2006-06-02 |
| 1811547540 | Revered Medical, LLC | Clinic/Center | 6246 Montrose Rd, North Bethesda, MD 20852-4119 | 2019-09-15 |
| 1215585336 | Wellness Infusions | Clinic/Center | 5430 Campbell Blvd Ste 111, White Marsh, MD 21162-5503 | 2019-09-02 |
| 1417418724 | Hydrxafuse, LLC | Clinic/Center | 49 Old Solomons Island Rd Ste 104, Annapolis, MD 21401-3861 | 2019-03-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.