NURSE MANAGED WELLNESS CLINIC
NPI 1013463561
Nurse Practitioner - Family in Cumberland, MD

NPI Status: Active since August 25, 2016

Contact Information

12401 WILLOWBROOK RD
CUMBERLAND, MD
ZIP 21502
Phone: (301) 784-5670
Fax: (301) 784-5093

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  • Organization
  • Nurse Practitioner
  • Family
  • CLIA Number: 21D2093034
  • CLIA Cert. Type: School/Student Health Service
  • CLIA Exp. Date: 03-18-2027

About NURSE MANAGED WELLNESS CLINIC

This page provides the complete NPI Profile along with additional information for Nurse Managed Wellness Clinic, a provider established in Cumberland, Maryland operating as a Nurse Practitioner, focusing in family . The healthcare provider is registered in the NPI registry with number 1013463561 assigned on August 2016. The practitioner's primary taxonomy code is 363LF0000X with license number R081546 (MD). The provider is registered as an organization and their NPI record was last updated 9 years ago. The provider's is doing business as Nurse Managed Wellness Clinic. The authorized official of this NPI record is Mrs. Anna Kephart (Office Manager)

NPI
1013463561
Provider Legal Name
ALLEGANY COLLEGE OF MARYLAND
Other Organization Name
NURSE MANAGED WELLNESS CLINIC
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
12401 WILLOWBROOK RD CUMBERLAND, MD 21502
Location Phone
(301) 784-5670
Location Fax
(301) 784-5093
Mailing Address
12401 WILLOWBROOK RD CUMBERLAND, MD 21502
Mailing Phone
(301) 784-5670
Mailing Fax
(301) 784-5093
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-25-2016
Last Update Date
04-28-2017
Code Navigator

A nurse practitioner (NP) like Nurse Managed Wellness Clinic is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Location Map

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

Nurse Practitioner Family

Taxonomy Code
363LF0000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
R081546
License State
MD

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1291U00000XLaboratories

Clinical Medical Laboratory

21D2093034 (MD)
2363LF0000XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner
Family

R095433 (MD)

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. ANNA KEPHART

Authorized Official Title
OFFICE MANAGER
Authorized Official Phone
(301) 784-5670

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
21D2093034
Facility Type
School/Student Health Service
Certificate Effective Date
March 19, 2025
Certificate Expiration Date
March 18, 2027
Laboratory Director
TRACIE L. KOONTZ
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Nurse Managed Wellness Clinic 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 1013463561, 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.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
1
Doubled → 2
Pos 4
3
Unchanged
Pos 5
4
Doubled → 8
Pos 6
6
Unchanged
Pos 7
3
Doubled → 6
Pos 8
5
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
1
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 1 → 2 4 → 8 3 → 6 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 2 + 3 + 8 + 6 + 6 + 5 + 1 + 2 + 24 = 59

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.

60 - 59 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1013463561.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Dentist (General Practice)
12401 WILLOWBROOK RD
CUMBERLAND, MD 21502
Nurse Practitioner (Family)
12401 WILLOWBROOK RD
CUMBERLAND, MD 21502
Nurse Practitioner (Family)
12401 WILLOWBROOK RD, ALLIED HEALTH BUILDING, ROOM 115
CUMBERLAND, MD 21502
Registered Nurse
12401 WILLOWBROOK RD
CUMBERLAND, MD 21502

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1013463561, enumerated as an "organization" on August 25, 2016.

The provider is located at 12401 WILLOWBROOK RD CUMBERLAND, MD 21502 and the phone number is (301) 784-5670.

Nurse Practitioner with taxonomy code 363LF0000X and a focus in Family.