CLEANSE CLINIC, PLLC
NPI 1659726628
Psychiatry & Neurology - Addiction Psychiatry in Louisville, KY
About Cleanse Clinic, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CLEANSE CLINIC, PLLC (NPI 1659726628) is a healthcare organization registered as an addiction psychiatry in Louisville, Kentucky and active in the NPI registry since April 2016. The organization holds a CLIA Certificate of Compliance certificate valid through March 5, 2027, maintains 2 additional practice locations, and lists Margaret Ann Groll, Credentialing Specialist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Locations 2
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Cleanse Clinic, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Cleanse Clinic, PLLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 4 within 10 miles. They are listed nearest first.
Clinicians, nearest first (5)
Louisville, KY 40203
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Compliance 18D2120455
Cleanse Clinic Psc · Louisville, KYFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Cleanse Clinic, PLLC's NPI number?
The NPI number for Cleanse Clinic, PLLC is 1659726628. It was assigned to this organization in the NPPES registry on April 27, 2016.
Where is Cleanse Clinic, PLLC located?
Cleanse Clinic, PLLC is located at 645 S Roy Wilkins Ave Ste 100, Louisville, KY 40203. The listed phone number is (502) 583-4092.
What is Cleanse Clinic, PLLC's specialty?
The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Addiction Psychiatry, with taxonomy code 2084P0802X.
Is Cleanse Clinic, PLLC enrolled in Medicare?
Yes. Cleanse Clinic, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Cleanse Clinic, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 3 Medicare specialties reassign their Medicare billing to Cleanse Clinic, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3), Internal Medicine (1) and Psychiatry (1). Of these, 2 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Cleanse Clinic, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 18D2120455) is associated with this NPI, valid through March 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Cleanse Clinic, PLLC accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter of Tennessee and Anthem Blue Cross and Blue Shield list Cleanse Clinic, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Cleanse Clinic, PLLC was last updated on October 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 24 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Cleanse Clinic, Pllc · NPI 1659726628
Addiction Psychiatry organization in Louisville, Kentucky. Organization record, active in the CMS NPPES registry since April 27, 2016.
## Identity
- **NPI:** 1659726628 (Entity type: Organization)
- **Enumerated:** April 27, 2016
- **Primary specialty:** Psychiatry & Neurology - Addiction Psychiatry · taxonomy 2084P0802X
- **Organization subpart:** No
- **Authorized official:** Margaret Groll, CREDENTIALING SPECIALIST
## Practice location
- **Address:** 645 S ROY WILKINS AVE STE 100, Louisville, KY 40203-2072
- **Phone:** (502) 583-4092 · **Fax:** (502) 371-6110
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Internal Medicine (1), Psychiatry (1); 2 practice at this address and 4 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 10, 2026
- **Other identifiers:** Medicaid 7100413630 (KY); Medicaid 300096732 (IN)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1659726628) · Data from the CMS NPPES public registry.