CARROLL L ACKLEY, LADC, CCS — NPI 1952709529 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in BANGOR, ME)

CMS-1500 Box 24J / 33a • NPI

1952709529

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

261QM2800X

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

74 DOWD RD, BANGOR, ME, 04401-6700

✓ 9-Digit EDI 837 ZIP+4 (04401-6700)

Practice Phone & Referral Fax

(207) 947-6800

Fax: (207) 947-6872

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1952709529 (CARROLL L ACKLEY, LADC, CCS) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1952709529` (NPI-1 Individual Practitioner)
Provider / Legal Name	CARROLL L ACKLEY, LADC, CCS
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261QM2800X` (Clinic/Center, Methadone Clinic)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	74 DOWD RD, BANGOR, ME, 04401-6700
Practice Telephone / Fax	Tel: (207) 947-6800 \| Fax: (207) 947-6872
Administrative Mailing Address	74 DOWD RD, BANGOR, ME, 04401-6700
Enumeration & Last Sync	Enumerated: 2014-12-15 \| CMS Record Updated: 2014-12-15

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

74 DOWD RD, BANGOR, ME, 04401-6700

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Plain-English Taxonomy & CMS Crosswalk (261QM2800X)

What Does Taxonomy Code 261QM2800X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QM2800X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (CARROLL L ACKLEY, LADC, CCS)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261QM2800X` — Clinic/Center, Methadone Clinic Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: ME \| License: `LC1222` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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CARROLL L ACKLEY, LADC, CCS (NPI #1952709529)