NPIMap

Organization Active NPI

Ultimate Care Medical Services LLC

  • Methadone Clinic
  • Ashland, KY
National Provider Identifier
1194954875
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
License
KY-10054-M Issued in KY
Legal business name
ULTIMATE CARE MEDICAL SERVICES LLC
Practice address
3655 Winchester Ave
Ashland, KY 41101-2065
Phone
(606) 393-4632
Fax
(888) 411-4131
NPI assigned
Jul 2, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Authorized official

Name
Rose Uradu
Title
Program Director
Phone
(606) 393-4632

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X 810271 KY
Addiction Medicine (Family Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207QA0401X 40541 KY
Methadone Clinic 261QM2800X KY-10054-M KY Primary
Clinic Pharmacy 3336C0002X 10054 KY

Addresses

Primary practice location

3655 Winchester Ave
Ashland, KY 41101-2065

Mailing address

3655 Winchester Ave
Ashland, KY 41101-2065
Phone (606) 393-4632

Other identifiers 2

IdentifierTypeStateIssuer
7100090030MedicaidKY
1832977OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • Ultimate Treatment Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191203001969 KY Part B Supplier - Opioid Treatment Program (Otp) 2163578022 Practice locations: Ashland, KY

National Provider Directory

National Provider Directory

Locations

3566 Winchester Ave
KY 41101

2154 Carter Ave
Ste B
Ashland, KY 41101
Phone (606) 393-4632

Practitioners & affiliated clinicians

Practitioners 2

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": "1246492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1194954875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3655 WINCHESTER AVE",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012065",
            "telephone_number": "606-393-4632",
            "fax_number": "888-411-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 WINCHESTER AVE",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012065",
            "telephone_number": "606-393-4632",
            "fax_number": "888-411-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTIMATE CARE MEDICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-02",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "URADU",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "606-393-4632"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "810271",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "KY",
            "license": "40541",
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "KY",
            "license": "KY-10054-M",
            "primary": true
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "KY",
            "license": "10054",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100090030",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1832977",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ultimate Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ultimate Treatment Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ashland, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.