HUMBOLDT RIDGE DIALYSIS CENTER
NPI 1043491194
Clinic/Center in Milwaukee, WI

NPI Status: Active since November 16, 2007

Contact Information

2211 N HUMBOLDT BLVD
MILWAUKEE, WI
ZIP 53212
Phone: (414) 336-7200
Fax: (414) 777-5210

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  • Organization
  • Clinic/Center
  • CLIA Number: 52D2013611
  • CLIA Cert. Type: End Stage Renal Disease Dialysis Facility
  • CLIA Exp. Date: 09-21-2026

About HUMBOLDT RIDGE DIALYSIS CENTER

This page provides the complete NPI Profile along with additional information for Humboldt Ridge Dialysis Center, a provider established in Milwaukee, Wisconsin operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1043491194 assigned on November 2007. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 18 years ago. The provider's is doing business as Humboldt Ridge Dialysis Center. The authorized official of this NPI record is Mr. Barry Lee Luckenbill (Managing Member)

NPI
1043491194
Provider Legal Name
GARFIELD DIALYSIS VENTURE LLC
Other Organization Name
HUMBOLDT RIDGE DIALYSIS CENTER
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
2211 N HUMBOLDT BLVD MILWAUKEE, WI 53212
Location Phone
(414) 336-7200
Location Fax
(414) 777-5210
Mailing Address
2514 S 102ND ST SUITE 120 WEST ALLIS, WI 53227
Mailing Phone
(414) 777-5200
Mailing Fax
(414) 777-5210
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-16-2007
Last Update Date
12-27-2007
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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

Clinic/Center

Taxonomy Code
261Q00000X
Type
Ambulatory Health Care Facilities
Taxonomy Description
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

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

MR. BARRY LEE LUCKENBILL

Authorized Official Title
MANAGING MEMBER
Authorized Official Phone
(414) 777-5200

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
52D2013611
Facility Type
End Stage Renal Disease Dialysis Facility
Certificate Effective Date
September 22, 2024
Certificate Expiration Date
September 21, 2026
Laboratory Director
DR. KAMAL AMIN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Humboldt Ridge Dialysis Center 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 1043491194, we treat the final digit (4) 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 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

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
4
Doubled → 8
Pos 4
3
Unchanged
Pos 5
4
Doubled → 8
Pos 6
9
Unchanged
Pos 7
1
Doubled → 2
Pos 8
1
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
4
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 4 → 8 4 → 8 1 → 2 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

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

2 + 0 + 8 + 3 + 8 + 9 + 2 + 1 + 1 + 8 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1043491194.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
2211 N HUMBOLDT BLVD
MILWAUKEE, WI 53212

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1043491194, enumerated as an "organization" on November 16, 2007.

The provider is located at 2211 N HUMBOLDT BLVD MILWAUKEE, WI 53212 and the phone number is (414) 336-7200.

Clinic/Center with taxonomy code 261Q00000X.