GLEN S LOVELACE MD PA
NPI 1023053204
Specialist in Boise, ID

NPI Status: Active since June 19, 2006

Contact Information

333 N 1ST ST STE 260
BOISE, ID
ZIP 83702
Phone: (208) 345-3136
Fax: (208) 345-0984

NPI Profile Information
Primary Taxonomy
Group Taxonomy
Insurance Plans Accepted
Authorized Official
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Specialist
Accepts Insurance

About GLEN S LOVELACE MD PA

This page provides the complete NPI Profile along with additional information for Glen S Lovelace Md Pa, a provider established in Boise, Idaho operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1023053204 assigned on June 2006. The practitioner's primary taxonomy code is 174400000X with license number M6570 (ID). The provider is registered as an organization and their NPI record was last updated 16 years ago. The organization 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 Dr. Glen S Lovelace Md (Owner)

NPI: 1023053204
Provider Name: GLEN S LOVELACE MD PA
Entity Type: Organization
Location Address: 333 N 1ST ST STE 260 BOISE, ID 83702
Location Phone: (208) 345-3136
Location Fax: (208) 345-0984
Mailing Address: 333 N 1ST ST STE 260 BOISE, ID 83702
Mailing Phone: (208) 345-3136
Mailing Fax: (208) 345-0984
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 06-19-2006
Last Update Date: 06-01-2009
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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: Specialist
Taxonomy Code: 174400000X
Type: Other Service Providers
License No.: M6570
License State: ID
Taxonomy Description: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Moda Health Plan, Inc.

Moda Health Affinity Bronze 7750 - EPO
Moda Health Affinity Bronze 9000 - EPO
Moda Health Affinity Bronze HDHP 7500 - EPO
Moda Health Affinity Gold 1000 - EPO
Moda Health Affinity Gold 1500 - EPO
Moda Health Affinity Gold 250 - EPO
Moda Health Affinity Silver 3000 - EPO
Moda Health Affinity Silver 3400 - EPO
Moda Health Affinity Silver 4500 - EPO
Moda Health Affinity Silver 6000 - EPO
Moda Health Oregon Standard Bronze Affinity - EPO
Moda Health Oregon Standard Gold Affinity - EPO
Moda Health Oregon Standard Silver Affinity - EPO

Mountain Health CO-OP

Connect Bronze Expanded Standard - PPO
Connect Bronze HDHP - PPO
Connect Catastrophic - PPO
Connect Gold - PPO
Connect Gold Standard - PPO
Connect Silver - PPO
Connect Silver Standard - PPO
High Plains Bronze HDHP - PPO
High Plains Bronze Standard Expanded - PPO
High Plains Gold - PPO
High Plains Gold HDHP - PPO
High Plains Gold Standard - PPO
High Plains Silver - PPO
High Plains Silver Standard - PPO
Plus Bronze Expanded - PPO
Plus Bronze Standard Expanded - PPO
Plus Gold - PPO
Plus Gold Standard - PPO
Plus Silver Standard - PPO
ACCESS BRONZE - PPO

Blue Cross Blue Shield

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

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: DR. GLEN S LOVELACE MD
Authorized Official Title: OWNER
Authorized Official Phone: (208) 345-3136

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State	Identifier Issuer
000010028711	OTHER (01)	ID	BLUE SHIELD GROUP NUMBER
8D608	OTHER (01)	ID	BLUE CROSS GROUP NUMBER
1377264	MEDICARE ID-TYPE UNSPECIFIED (04)	ID	GROUP NUMBER

NPI Validation Check Digit Calculation

The following table explains the step by step 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.
1	0	2	3	0	5	3	2	0	4
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	0	4	3	0	5	6	2	0
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 0 + 4 + 3 + 0 + 5 + 6 + 2 + 0 + 24 = 46
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 46 = 4									4

The NPI number 1023053204 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.