MEDALLION MANOR INC
NPI 1043518145
Intermediate Care Facility, Intellectual Disabilities in Payson, UT
NPI Status: Active since March 14, 2011
Contact Information
2192 W STATE RD
PAYSON, UT
ZIP 84651
Phone: (801) 375-2710
Fax: (801) 377-3651
- Organization
- Intermediate Care Facility, Intellectual...
- CLIA Number: 46D0525403
- CLIA Cert. Type: Intermediate Care Facility for Mentally Retarded
- CLIA Exp. Date: 08-31-2026
About MEDALLION MANOR INC
This page provides the complete NPI Profile along with additional information for Medallion Manor Inc, a provider established in Payson, Utah operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1043518145 assigned on March 2011. The practitioner's primary taxonomy code is 315P00000X with license number 2011-SHCF-100069 (UT). The provider is registered as an organization and their NPI record was last updated 15 years ago. The provider's is doing business as Medallion Manor Inc. The authorized official of this NPI record is Mr. Merlin Moyes Jr. (Owner)
- NPI
- 1043518145
- Provider Legal Name
- MEDALLION SUPPORTED LIVING-PAYSON
- Other Organization Name
- MEDALLION MANOR INC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 2192 W STATE RD PAYSON, UT 84651
- Location Phone
- (801) 375-2710
- Location Fax
- (801) 377-3651
- Mailing Address
- PO BOX 51377 PROVO, UT 84605
- Mailing Phone
- (801) 375-2710
- Mailing Fax
- (801) 377-3651
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-14-2011
- Last Update Date
- 03-14-2011
- Code Navigator
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
Intermediate Care Facility, Intellectual Disabilities
- Taxonomy Code
- 315P00000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- 2011-SHCF-100069
- License State
- UT
- Taxonomy Description
- An intermediate care facility providing services for individuals with intellectual disabilities.
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
- 46D0525403
- Facility Type
- Intermediate Care Facility for Mentally Retarded
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- HEATHER FRAUGHTON
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Medallion Manor Inc 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 1043518145, we treat the final digit (5) 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 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 55 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1043518145, enumerated as an "organization" on March 14, 2011.
The provider is located at 2192 W STATE RD PAYSON, UT 84651 and the phone number is (801) 375-2710.
Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.
