BREMEN FAMILY MEDICINE NPI 1003023987

General Practice in Bremen, GA

NPI 1003023987 Organization General Practice CLIA Number 11D1067856 CLIA Certificate of Waiver

NPI Profile for BREMEN FAMILY MEDICINE

Bremen Family Medicine is a primary care provider established in Bremen, Georgia specializing in general practice. The NPI number of Bremen Family Medicine is 1003023987 and was assigned on May 2007. The practitioner's primary taxonomy code is 208D00000X with license number 034852 (GA). The provider is registered as an organization and their NPI record was last updated 2 years ago. Bremen Family Medicine operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Regina L Holloway Md (Owner)

A primary care provider (PCP) like Bremen Family Medicine sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

The CLIA number of Bremen Family Medicine is 11D1067856 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Bremen Family Medicine 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.

NPI

1003023987

Provider NameBREMEN FAMILY MEDICINE
Provider Location Address308 CARROLLTON ST BREMEN, GA 30110
Provider Mailing Address327 OLD BUSHMILL RD BREMEN, GA 30110
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date05-17-2007
Last Update Date08-22-2020


Primary Taxonomy

Taxonomy Code208D00000X
ClassificationGeneral Practice
TypeAllopathic & Osteopathic Physicians
License No.034852
License StateGA

Business Address

BREMEN FAMILY MEDICINE
308 CARROLLTON ST
BREMEN, GA
ZIP 30110
Phone: (770) 537-1960
Fax: (770) 537-1901

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Mailing Address

BREMEN FAMILY MEDICINE
327 OLD BUSHMILL RD
BREMEN, GA
ZIP 30110
Phone: (770) 537-1960
Fax: (770) 537-1901



Authorized Official

Authorized Official Name REGINA L HOLLOWAY MD
Authorized Official TitleOWNER
Authorized Official Phone(770) 537-1960

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 the NPI number 1003023987 is:

CLIA Number11D1067856
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
00478552HMEDICAID (05)GA

NPI Validation Check Digit Calculation


The following table explains step by step the NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1003023987
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2003026916
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 0 + 3 + 0 + 2 + 6 + 9 + 1 + 6 + 24 = 53
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 53 = 77

The NPI number 1003023987 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
Bremen Family Medicine is registered as an entity type code: 2. The entity type code describes the type of health care provider that is being assigned an NPI. The entity type codes are:

  • 1 = Person: individual human being who furnishes health care.
  • 2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.