Chillicothe Acute Care Clinic, Inc.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

01-7606 Issued in OH

Legal business name

CHILLICOTHE ACUTE CARE CLINIC, INC.

Practice address

3 Medical Dr
Chillicothe, OH 45601-8603

Phone

(740) 779-6614

Fax

(740) 779-6617

NPI assigned

Nov 2, 2010

Organization subpart

No

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

Authorized official

Name

Michelle A Galloway

Title

President

Phone

(985) 726-9605

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Anchor Addiction and Wellness Center Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Chillicothe Acute Care Clinic, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Toledo, OH
  • NPI 1689271827

  O20190724000748

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/anchoraddiction/r4/

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Karlota May, APRN

  • Family Nurse Practitioner
  • Gallipolis, OH
  • NPI 1356046338
  Medicare reassignment Care Compare group NPD
• Regina Preston, FNP-C

  • Family Nurse Practitioner
  • Toledo, OH
  • NPI 1316583180
  Medicare reassignment Care Compare group NPD
• Jason L Rich, M.D.

  • Addiction Medicine (Family Medicine) Physician
  • Wilmington, OH
  • NPI 1003815689
  Medicare reassignment Care Compare group NPD
• Raju Fatehchand, MD FACP

  • Internal Medicine Physician
  • Newark, OH
  • NPI 1346201407
  Medicare reassignment NPD
• Emily Estella Jackson, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Toledo, OH
  • NPI 1831790328
  NPD (past)
• Joshua Thacker, CDCA, QMHS

  • Addiction (Substance Use Disorder) Counselor
  • Brookfield, OH
  • NPI 1710585369
  NPD (past)

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

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621209600000",
    "number": "1003116344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704590160",
            "telephone_number": "198-572-6960",
            "fax_number": "985-726-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MEDICAL DR",
            "city": "CHILLICOTHE",
            "state": "OH",
            "postal_code": "456018603",
            "telephone_number": "740-779-6614",
            "fax_number": "740-779-6617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5555 Airport Hwy Ste 132",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436157380",
            "country_code": "US",
            "telephone_number": "567-742-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHILLICOTHE ACUTE CARE CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-02",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A",
        "authorized_official_last_name": "GALLOWAY",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "985-726-9605"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "OH",
            "license": "01-7606",
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0271632",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anchor Addiction and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Taresa Fay Chesebro
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• Brandon M Chester, O.D.
• Michael E Chester, O.D.
• Chilicothe Vamc
• Chillicothe Anesthesia Associates Inc
• Chillicothe Bone & Joint Specialists Inc
• Chillicothe Chiropractic and Wellness Center Inc
• Chillicothe City School District
• Chillicothe Eye Care LLC

• Substance Use Disorder Rehabilitation Clinic/Center in Chillicothe, OH
• Providers in Chillicothe, OH by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.

Verify at the official NPI Registry.