NPIMap

Organization Active NPI

Premier Care of Ohio, LLC

Doing business as CMS Elyria

  • Methadone Clinic
  • Elyria, OH
National Provider Identifier
1437915055
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
PREMIER CARE OF OHIO, LLC
Doing business as
CMS Elyria
Practice address
1508 W River Rd N
Elyria, OH 44035-2714
Phone
(601) 248-8886
NPI assigned
Feb 21, 2024
Last updated
May 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Authorized official

Name
Alejandra Vilchis
Title
Credentialing Provider Data Manager
Phone
(480) 977-1438

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Methadone Clinic 261QM2800X NU Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

1508 W River Rd N
Elyria, OH 44035-2714

Mailing address

8444 N 90TH St Ste 100
Scottsdale, AZ 85258-4437
Phone (602) 248-8886

Other names 1

  • CMS ELYRIA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200508000963 OH Part B Supplier - Opioid Treatment Program (Otp) 7719318690 17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cleveland, OH; Lima, OH; Kettering, OH; Elyria, OH; Columbus, OH; Cincinnati, OH; Akron, OH

Other NPIs on the same Medicare enrollment 17

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

View all 17

National Provider Directory

National Provider Directory
Tax ID family
Premier Care of Ohio LLC27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Locations

8444 N 90th St
Ste 100
Scottsdale, AZ 85258
Phone (480) 494-2497

Practitioners & affiliated clinicians

Practitioners 3

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": "1708473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1437915055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8444 N 90TH ST STE 100",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584437",
            "telephone_number": "602-248-8886",
            "fax_number": "602-854-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 W RIVER RD N",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440352714",
            "telephone_number": "601-248-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CARE OF OHIO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "VILCHIS",
        "authorized_official_first_name": "ALEJANDRA",
        "authorized_official_title_or_position": "CREDENTIALING PROVIDER DATA MANAGER",
        "authorized_official_telephone_number": "480-977-1438"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMS ELYRIA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CMS ELYRIA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.