GEORGETOWN MEDICAL, LLC
NPI 1063824381
Clinic/Center - Methadone in Georgetown, KY
NPI Status: Active since May 21, 2014
Contact Information
105 EASTSIDE DR
GEORGETOWN, KY
ZIP 40324
Phone: (502) 868-0664
- Organization
- Clinic/Center
- Methadone
- CLIA Number: 18D2119759
- CLIA Cert. Type: Other - ALCOHOL AND DRUG TREATMEN
- CLIA Exp. Date: 10-03-2026
About GEORGETOWN MEDICAL, LLC
This page provides the complete NPI Profile along with additional information for Georgetown Medical, Llc, a provider established in Georgetown, Kentucky operating as a Clinic/center, focusing in methadone . The healthcare provider is registered in the NPI registry with number 1063824381 assigned on May 2014. The practitioner's primary taxonomy code is 261QM2800X with license number 810355 (KY). The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Robyn Tanis (Executive Director Of Contract Mgmt)
- NPI
- 1063824381
- Provider Name
- GEORGETOWN MEDICAL, LLC
- Entity Type
- Organization
- Location Address
- 105 EASTSIDE DR GEORGETOWN, KY 40324
- Location Phone
- (502) 868-0664
- Mailing Address
- 1317 ROUTE 73 STE 200 MOUNT LAUREL, NJ 08054
- Mailing Phone
- (856) 439-6111
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-21-2014
- Last Update Date
- 09-09-2021
- Code Navigator
Location Map
Secondary Locations
- 105 Eastside Dr Suites A, B, and C
Georgetown, KY 40324
(502) 868-0664
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Methadone
- Taxonomy Code
- 261QM2800X
- Type
- Ambulatory Health Care Facilities
- License No.
- 810355
- License State
- KY
- Taxonomy Description
- An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 810355 | OTHER (01) | KY | STATE LICENSE |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 18D2119759
- Facility Type
- Other - ALCOHOL AND DRUG TREATMEN
- Certificate Effective Date
- October 04, 2024
- Certificate Expiration Date
- October 03, 2026
- Laboratory Director
- DR. LORI N. LEGRAND
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Georgetown Medical, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1063824381, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 59 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
GEORGETOWN, KY 40324
GEORGETOWN, KY 40324
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063824381, enumerated as an "organization" on May 21, 2014.
The provider is located at 105 EASTSIDE DR GEORGETOWN, KY 40324 and the phone number is (502) 868-0664.
Clinic/Center with taxonomy code 261QM2800X and a focus in Methadone.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
