Georgetown Medical, LLC
NPI 1063824381 · Methadone Clinic · Georgetown, KY
Enrolled with Medicare as Part B Supplier - Opioid Treatment Program (otp) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Georgetown Medical, LLC is a Methadone Clinic organization in Georgetown, KY (NPI 1063824381).
Provider details
- NPI number
- 1063824381
- Entity type
- Organization
- Primary specialty
- Methadone ClinicAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Robyn Tanis, Executive Director of Contract Mgmt(856) 533-8762
- License
- 810355 (KY)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 105 Eastside DrSuites A, B, and CGeorgetown, KY 40324-9797Phone: (502) 868-0664
Registry dates
- Enumerated
- 2014-05-21
- Last updated
- 2021-09-09
- Certified
- 2021-09-09
Frequently asked questions
- What is Georgetown Medical, LLC's NPI number?
- Georgetown Medical, LLC's National Provider Identifier (NPI) is 1063824381, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Georgetown Medical, LLC?
- Georgetown Medical, LLC is classified in the NPPES registry as Methadone Clinic (Ambulatory Health Care Facilities).
- Where is Georgetown Medical, LLC located?
- Georgetown Medical, LLC's practice location on file with NPPES is 105 Eastside Dr, Georgetown, KY 40324-9797.
- What is Georgetown Medical, LLC's phone number?
- The practice phone number listed in the NPPES registry for Georgetown Medical, LLC is (502) 868-0664.
- Does Georgetown Medical, LLC accept Medicare?
- Georgetown Medical, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Georgetown Medical, LLC?
- The authorized official listed on Georgetown Medical, LLC's NPPES record is Robyn Tanis, Executive Director of Contract Mgmt. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Georgetown Medical, LLC's NPI active?
- Yes — Georgetown Medical, LLC's NPI (1063824381) is active in the NPPES registry as of the last update on 2021-09-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.