Recovery Concepts Urbana, LLC

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

Legal business name

RECOVERY CONCEPTS URBANA, LLC

Practice address

710 W. Killarney St.
Urbana, IL 61801

Phone

(985) 705-3263

NPI assigned

Jul 24, 2020

Organization subpart

Yes

Parent organization

RECOVERY CONCEPTS HOLDINGS, LLCAs reported in NPPES

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

Authorized official

Name

Dr. Richard Mankinen, MD

Title

Director

Phone

(708) 335-1155

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Opioid treatment program

Medicare-enrolled since Dec 15, 2021

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Heather Renee Irelan, PMHNP-BC, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Champaign, IL
  • NPI 1881139905
  NPD
• Usha D Malkerneker, MD

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Hazel Crest, IL
  • NPI 1568525277
  NPD
• Dee Malkerneker, MD

  • Vascular & Interventional Radiology Physician
  • Gretna, LA
  • NPI 1619024593
  NPD

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

{
    "created_epoch": "1595548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606176000000",
    "number": "1922617133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12489 JOSEPHS RD",
            "city": "FOLSOM",
            "state": "LA",
            "postal_code": "704375829",
            "telephone_number": "985-705-3263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 W. KILLARNEY ST.",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801",
            "telephone_number": "985-705-3263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECOVERY CONCEPTS URBANA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RECOVERY CONCEPTS HOLDINGS, LLC",
        "enumeration_date": "2020-07-24",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A",
        "authorized_official_last_name": "MANKINEN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "708-335-1155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPR ILLINOIS",
            "identifier": "A-3516-0001-A",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A-3516-0001-A",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Partha S Ray, MD
• Patricia A Ray, LCSW
• Vanessa B Ream, LCSW
• Janelle Rear, DNP, APRN, CRNA
• Katherine Rebman, NP
• Sukhila Baddam Reddy
• Jason Redeker, D.P.T.
• Kristine Redfield, APRN, CNP
• Joshua M Reeves, PA
• Kira Lynn Reich, MD

• Methadone Clinic in Urbana, IL
• Providers in Urbana, IL by specialty
• Methadone Clinic in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.