NPIMap

Organization Active NPI

Limestone Health, LLC

Doing business as MedMark Treatment Centers LaFayette

  • Methadone Clinic
  • Lafayette, IN
National Provider Identifier
1659879187
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
LIMESTONE HEALTH, LLC
Doing business as
MedMark Treatment Centers LaFayette
Practice address
4705 Meijer CT
Lafayette, IN 47905-4684
Phone
(765) 743-4400
NPI assigned
Jan 30, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Bruce Jarvie
Title
VP, Treasurer
Phone
(214) 379-3300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

4705 Meijer CT
Lafayette, IN 47905-4684

Mailing address

1720 Lakepointe Dr Ste 117
Lewisville, TX 75057-6425
Phone (214) 379-3300

Other names 1

  • MedMark Treatment Centers LaFayette Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opioid treatment program
Medicare-enrolled since Aug 4, 2026

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2145441Limestone Health, LLC Medmark Treatment Centers4705 Meijer Court, Lafayette, IN 47905Certificate of waiverMar 6, 2028

National Provider Directory

National Provider Directory
Tax ID family
Limestone Health LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2100 S Liberty Dr
Ste A
Bloomington, IN 47403
Phone (812) 727-6700

4705 Meijer Ct
Lafayette, IN 47905
Phone (765) 701-6060

Practitioners & affiliated clinicians

Practitioners 12

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": "1517270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1659879187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 LAKEPOINTE DR STE 117",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750576425",
            "telephone_number": "214-379-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 MEIJER CT",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054684",
            "telephone_number": "765-743-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIMESTONE HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-30",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "JARVIE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "VP, TREASURER",
        "authorized_official_telephone_number": "214-379-3300"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedMark Treatment Centers LaFayette",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.