NPIMap

Organization Active NPI

Amazing Grace Center Inc

  • Methadone Clinic
  • Portsmouth, OH
National Provider Identifier
1205188588
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
AMAZING GRACE CENTER INC
Practice address
802 Clare Ave
Portsmouth, OH 45662
Phone
(740) 876-8449
NPI assigned
Oct 10, 2012
Last updated
Oct 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

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

Authorized official

Name
Rose Onyinyechi Uradu, MDNPI 1326050634
Title
Medical Director
Phone
(606) 393-4632

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X NU Primary
Community/Behavioral Health Agency 251S00000X 13303 OH

Addresses

Primary practice location

802 Clare Ave
Portsmouth, OH 45662

Mailing address

802 Clare Ave
Portsmouth, OH 45662
Phone (740) 876-8449

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191122001791 OH Part B Supplier - Opioid Treatment Program (Otp) 7416187711 Practice locations: Portsmouth, OH

National Provider Directory

National Provider Directory

Locations

802 Clare Ave
Portsmouth, OH 45662
Phone (740) 876-8449

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1349827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664841600000",
    "number": "1205188588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 CLARE AVE",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "45662",
            "telephone_number": "740-876-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 CLARE AVE",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "45662",
            "telephone_number": "740-876-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMAZING GRACE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-10",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A",
        "authorized_official_last_name": "URADU",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "ONYINYECHI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "606-393-4632",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OH",
            "license": "13303",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.