NPIMap

Organization Active NPI

Elevate Healthcare LLC

  • Methadone Clinic
  • Pueblo, CO
National Provider Identifier
1801595194
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
ELEVATE HEALTHCARE LLC
Practice address
212 W 13TH St
Pueblo, CO 81003-3754
Phone
(719) 470-1415
NPI assigned
Feb 27, 2023
Last updated
Feb 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Authorized official

Name
Ursula Hollins, LAC MSW LPNNPI 1073710216
Title
Executive Director
Phone
(719) 470-1415

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X NU Primary

Addresses

Primary practice location

212 W 13TH St
Pueblo, CO 81003-3754

Mailing address

212 W 13TH St
Pueblo, CO 81003-3754
Phone (719) 470-1415

Other identifiers 2

IdentifierTypeStateIssuer
308OtherCOSTATE OF COLORADO CONTROLLED SUBSTANCE
2542-01OtherCOSTATE OF COLORADO SUD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Opioid treatment program
Medicare-enrolled since Jan 12, 2024

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230824001637 CO Part B Supplier - Opioid Treatment Program (Otp) 1355704313 Practice locations: Pueblo, CO

National Provider Directory

National Provider Directory
Tax ID family
Elevate Healthcare LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

Subparts reporting this organization as parent 3

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": "1677456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677456000000",
    "number": "1801595194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 W 13TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033754",
            "telephone_number": "719-470-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W 13TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033754",
            "telephone_number": "719-470-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-26",
        "status": "A",
        "authorized_official_last_name": "HOLLINS",
        "authorized_official_first_name": "URSULA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "719-470-1415",
        "authorized_official_credential": "LAC MSW LPN"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF COLORADO CONTROLLED SUBSTANCE",
            "identifier": "308",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF COLORADO SUD",
            "identifier": "2542-01",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; 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.